Active NPI
New Creation Healing Center, Inc
- Family Medicine Physician
- Kingston, NH
National Provider Identifier
1477569234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- NEW CREATION HEALING CENTER, INC
- Practice address
- 80 Route 125
Kingston, NH 03848-3535 - Phone
- (603) 642-6700
- Fax
- (603) 642-6701
- NPI assigned
- Aug 1, 2006
- 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
- Mary G Pearson, DO
- Title
- Coo/Physician
- Phone
- (603) 642-6700
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
80 Route 125
Kingston, NH 03848-3535
Mailing address
80 Route 125
Kingston, NH 03848-3535
Phone (603) 642-6700
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30900090 | Medicaid | NH | |
| 9785515 | Medicaid | MA | |
| BCBS | Other | MA | M17086 |
| TUFTS | Other | MA | 681554 |
| HEALTHSOURCE | Other | NH | 15221 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH, MA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060407000564 | NH | Part B Supplier - Clinic/Group Practice | 7911916663 |
Receives reassigned benefits from 3 practitioners Practice locations: Kingston, NH |
| O20090320000220 | MA | Part B Supplier - Clinic/Group Practice | 7911916663 |
Receives reassigned benefits from 1 practitioner Practice locations: Haverhill, MA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 30D0878544 | New Creation Healing Center | Provider-performed microscopy | Sep 11, 2026 |
National Provider Directory
National Provider DirectoryLocations
80 Route 125
Kingston, NH 03848
Phone (603) 382-7391
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Kingston, NH
- NPI 1699459214
-
- Clinical Social Worker
- Kingston, NH
- NPI 1972649853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1236211200000",
"number": "1477569234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 ROUTE 125",
"city": "KINGSTON",
"state": "NH",
"postal_code": "038483535",
"telephone_number": "603-642-6700",
"fax_number": "603-642-6701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 ROUTE 125",
"city": "KINGSTON",
"state": "NH",
"postal_code": "038483535",
"telephone_number": "603-642-6700",
"fax_number": "603-642-6701"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW CREATION HEALING CENTER, INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-01",
"last_updated": "2009-03-05",
"status": "A",
"authorized_official_last_name": "PEARSON",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "COO/PHYSICIAN",
"authorized_official_telephone_number": "603-642-6700",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30900090",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9785515",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "M17086",
"identifier": "BCBS",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "681554",
"identifier": "TUFTS",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "15221",
"identifier": "HEALTHSOURCE",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kingston, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.