Individual provider Active NPI

Jennifer Mann, NP

  • Family Nurse Practitioner
  • Hudson, NH
National Provider Identifier
1467990085
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
081555-23 Issued in NH
Practice address
300 Derry Rd
Hudson, NH 03051-3023
Phone
(603) 886-3979
Fax
(603) 886-2898
NPI assigned
Feb 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN282048 MA
Student in an Organized Health Care Education/Training Program 390200000X RN282048 MA
Family Nurse Practitioner 363LF0000X 081555-23 NH Primary

Addresses

Primary practice location

300 Derry Rd
Hudson, NH 03051-3023

Mailing address

PO Box 3677
Nashua, NH 03061-3677
Phone (603) 577-7900

Other identifiers 2

IdentifierTypeStateIssuer
110132387AMedicaidMA
S400461117OtherMAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180409001464 MA Practitioner - Nurse Practitioner 9638432438 Reassigns benefits to 2 organizations
I20200120001083 NH Practitioner - Nurse Practitioner 9638432438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Foundation Medical Partners IncGroup PAC ID 9436140456, 313 clinicians

Practice addresses (Care Compare)

300 Derry Rd
Hudson, NH 03051-3023
Phone (603) 886-3979

Hospital & facility affiliations

  • Home Health & Hospice Care Home health agency, Merrimack, NH, CCN 307017
  • Amedisys Home Health Home health agency, Portsmouth, NH, CCN 307006
  • Southern NH Medical Center Hospital, Nashua, NH, CCN 300020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
081555-23NHMDFamily Nurse Practitioner
RN282048MAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Heywood Medical Group Inc. Nurse Practitioner CurrentSince Apr 1, 2018 Accepting new patients
Foundation Medical Partners Inc. CurrentSince Sep 1, 2022 Accepting new patients
Foundation Medical Partners Inc CurrentSince Sep 1, 2022 Accepting new patients
Athol Memorial Hospital Incorporated Nurse Practitioner CurrentSince Apr 1, 2018 Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

250 Green St
Gardner, MA 01440
Phone (978) 630-5050

266 Main St
Gardner, MA 01440
Phone (978) 630-5030

300 Derry Rd
Hudson, NH 03051
Phone (603) 579-5472

10 Jones Rd
Milford, NH 03055
Phone (603) 672-7600

22 Cotton Rd
Nashua, NH 03063
Phone (603) 899-6147

Interoperability endpoints

  • Direct secure messaging: jmann141736@direct.solutionhealth.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 and National Provider Directory roles.

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": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1467990085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3677",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030613677",
            "telephone_number": "603-577-7900",
            "fax_number": "603-577-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 DERRY RD",
            "city": "HUDSON",
            "state": "NH",
            "postal_code": "030513023",
            "telephone_number": "603-886-3979",
            "fax_number": "603-886-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN282048",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "RN282048",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "081555-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110132387A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "S400461117",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, NH

Sources for this page

Verify at the official NPI Registry.