Active NPI
Frederick Peter Spin, M.D.
- Gastroenterology Physician
- Keene, NH
National Provider Identifier
1487687224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 1204
- Practice address
- 590 Court St
Keene, NH 03431-1719 - Phone
- (603) 354-5454
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 1204 | NH | Primary |
| Gastroenterology Physician | 207RG0100X | G31103 | CA | |
| Gastroenterology Physician | 207RG0100X | MD00041085 | WA |
Addresses
Primary practice location
590 Court St
Keene, NH 03431-1719
Mailing address
590 Court St
Keene, NH 03431-1719
Phone (603) 354-5454
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30203424 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G31103 | CA | MD | Gastroenterology Physician |
| MD00041085 | WA | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334188800000",
"number": "1487687224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "590 COURT ST",
"city": "KEENE",
"state": "NH",
"postal_code": "034311719",
"telephone_number": "603-354-5454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 COURT ST",
"city": "KEENE",
"state": "NH",
"postal_code": "034311719",
"telephone_number": "603-354-5454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPIN",
"first_name": "FREDERICK",
"middle_name": "PETER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2012-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NH",
"license": "1204",
"primary": true
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "G31103",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "WA",
"license": "MD00041085",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30203424",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Keene, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.