Individual provider Active NPI

Karen J Doherty, APRN

  • Family Nurse Practitioner
  • Raymond, NH
National Provider Identifier
1497069637
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
061199-23 Issued in NH
Practice address
15 Freetown Rd
Raymond, NH 03077-2358
Phone
(604) 895-8000
NPI assigned
Jul 29, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 061199-23 NH Primary

Addresses

Primary practice location

15 Freetown Rd
Raymond, NH 03077-2358

Mailing address

15 Freetown Rd
Raymond, NH 03077-2358
Phone (604) 895-8000

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
I20110318000212 NH Practitioner - Nurse Practitioner 6507049277 Reassigns benefits to 2 organizations

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 Physicians NetworkGroup PAC ID 6406743988, 78 clinicians

Practice addresses (Care Compare)

25 Leavey Dr
Bedford, NH 03110-4437
Phone (603) 472-7233

275 Mammoth Rd
Manchester, NH 03109-4133

Hospital & facility affiliations

  • Elliot Hospital Hospital, Manchester, NH, CCN 300012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
061199-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Physicians Network CurrentSince Jan 24, 2011 Accepting new patients
Elliot Professional Services CurrentSince Mar 1, 2020 Accepting new patients

Locations

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

25 Leavey Dr
Ste 105
Bedford, NH 03110

275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222

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

15 Freetown Rd
Raymond, NH 03077
Phone (603) 895-8000

15 Freetown Rd
Ste 1
Raymond, NH 03077

Organizations & group practices 2

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 1

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": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1497069637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 FREETOWN RD",
            "city": "RAYMOND",
            "state": "NH",
            "postal_code": "030772358",
            "telephone_number": "604-895-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FREETOWN RD",
            "city": "RAYMOND",
            "state": "NH",
            "postal_code": "030772358",
            "telephone_number": "604-895-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOHERTY",
        "first_name": "KAREN",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-29",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "061199-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raymond, NH

Sources for this page

Verify at the official NPI Registry.