Donald Owen Kollisch, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

6251 Issued in NH

Practice address

93 E Wheelock St
Hanover, NH 03755-1605

Phone

(603) 643-5572

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  NPD (past)
• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1477572832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 E WHEELOCK ST",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037551605",
            "telephone_number": "603-643-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 E WHEELOCK ST",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037551605",
            "telephone_number": "603-643-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLLISCH",
        "first_name": "DONALD",
        "middle_name": "OWEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "6251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82086977",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendal at Hanover I
• Grace Prosperi Ketcham, PSYD
• Yusuf Ali Khan, MD
• Nancy Hayes Kilgore, D.MIN.
• Knight Pharmacy Inc
• Cassie A Kosarek, MD
• Brianna Morgan Krafcik, MD
• Daniel Kranseler
• Ktherapy and Brainspotting With Katherine
• Ktherapy and Brainspotting With Katherine

• Family Medicine Physician in Hanover, NH
• Providers in Hanover, NH by specialty
• Family Medicine Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.