Individual provider Active NPI

Susan Mary Thibodeau, BSN, MSN, ARNP

  • Pediatric Nurse Practitioner
  • Concord, NH
National Provider Identifier
1467471136
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
027347-23-02 Issued in NH
Practice address
253 Pleasant St
Concord, NH 03301-7560
Phone
(603) 226-6100
Fax
(603) 640-1228
NPI assigned
Jul 19, 2006
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 027347-23-02 NH Primary

Addresses

Primary practice location

253 Pleasant St
Concord, NH 03301-7560

Mailing address

253 Pleasant St
Concord, NH 03301-7560
Phone (603) 226-2200

Other identifiers 1

IdentifierTypeStateIssuer
30009565MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110221000188 NH Practitioner - Nurse Practitioner 0345421665 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Oct 1, 2015 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 1, 2023 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 1, 2023 Accepting new patients

Locations

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

253 Pleasant St
Concord, NH 03301
Phone (603) 226-2200

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

100 Hitchcock Way
Manchester, NH 03104
Phone (603) 629-1870

Interoperability endpoints

  • Direct secure messaging: sthibodeau16935@direct.dartmouth-hitchcock.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1467471136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033017560",
            "telephone_number": "603-226-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033017560",
            "telephone_number": "603-226-6100",
            "fax_number": "603-640-1228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "SUSAN",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "BSN, MSN, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NH",
            "license": "027347-23-02",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30009565",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.