Individual provider Active NPI

Kim C Brady, APRN

  • Nurse Practitioner
  • Manchester, NH
National Provider Identifier
1467767798
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
060016-23 Issued in NH
Practice address
185 Queen City Ave
Elliot Orthopaedic Surgery Specialists
Manchester, NH 03101-7100
Phone
(603) 625-1655
Fax
(603) 626-4686
NPI assigned
Aug 11, 2010
Last updated
Apr 13, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 060016-23 NH Primary

Addresses

Primary practice location

185 Queen City Ave
Elliot Orthopaedic Surgery Specialists
Manchester, NH 03101-7100

Mailing address

185 Queen City Ave
Elliot Orthopaedic Surgery Specialists
Manchester, NH 03101-7100
Phone (603) 625-1655

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
I20101014001175 NH Practitioner - Nurse Practitioner 4789877382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 622-6484

185 Queen City Ave
Manchester, NH 03101-7121
Phone (603) 314-6900

One Elliot Way
100 Elliot Cardiovascular Consultants
Manchester, NH 03103-3502
Phone (603) 627-1669

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
060016-23NHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Professional Services CurrentSince Aug 23, 2010 Accepting new patients

Locations

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

185 Queen City Ave
Manchester, NH 03101
Phone (603) 314-6900

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1467767798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "address_2": "ELLIOT ORTHOPAEDIC SURGERY SPECIALISTS",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017100",
            "telephone_number": "603-625-1655",
            "fax_number": "603-626-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "address_2": "ELLIOT ORTHOPAEDIC SURGERY SPECIALISTS",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017100",
            "telephone_number": "603-625-1655",
            "fax_number": "603-626-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "KIM",
        "middle_name": "C",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "060016-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.