Active NPI
Convenientmd LLC
- Clinical Medical Laboratory
- Salem, NH
National Provider Identifier
1467048348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- CONVENIENTMD LLC
- Practice address
- 8 Industrial Way Ste 4
Salem, NH 03079-4873 - Phone
- (603) 685-3340
- NPI assigned
- Dec 15, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jarod Boissonneault
- Title
- Director of Revenue Cycle MGT
- Phone
- (603) 319-6223
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
8 Industrial Way Ste 4
Salem, NH 03079-4873
Mailing address
111 NH Ave
Portsmouth, NH 03801-2864
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130410000222 | NH | Part B Supplier - Clinic/Group Practice | 2062667033 |
Receives reassigned benefits from 10 practitioners 18 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Windham, NH; Stratham, NH; Portsmouth, NH; Dover, NH; Plaistow, NH; Nashua, NH; Merrimack, NH; Manchester, NH… |
Other NPIs on the same Medicare enrollment 18
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
8 Industrial Way
Ste 4
Salem, NH 03079
Phone (603) 685-3340
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607990400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1607990400000",
"number": "1467048348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 NH AVE",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038012864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 INDUSTRIAL WAY STE 4",
"city": "SALEM",
"state": "NH",
"postal_code": "030794873",
"telephone_number": "603-685-3340"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONVENIENTMD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-12-15",
"last_updated": "2020-12-15",
"certification_date": "2020-12-15",
"status": "A",
"authorized_official_last_name": "BOISSONNEAULT",
"authorized_official_first_name": "JAROD",
"authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE MGT",
"authorized_official_telephone_number": "603-319-6223"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.