Active NPI
Vincent P McMahon, OD
- Optometrist
- Keene, NH
National Provider Identifier
1497711261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- NH323
- Practice address
- 474 West Street
Keene, NH 03431 - Phone
- (603) 352-7803
- Fax
- (603) 654-3165
- NPI assigned
- Apr 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | NH323 | NH | Primary |
Addresses
Primary practice location
474 West Street
Keene, NH 03431
Mailing address
474 West Street
Keene, NH 03431
Phone (603) 352-7803
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30356560 | Medicaid | NH | |
| 2210633 | Other | NH | CIGNA |
| 0907885Y0NH02 | Other | NH | ANTHEM |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376352000000",
"number": "1497711261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "474 WEST STREET",
"city": "KEENE",
"state": "NH",
"postal_code": "03431",
"telephone_number": "603-352-7803",
"fax_number": "603-354-3165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "474 WEST STREET",
"city": "KEENE",
"state": "NH",
"postal_code": "03431",
"telephone_number": "603-352-7803",
"fax_number": "603-654-3165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCMAHON",
"first_name": "VINCENT",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-21",
"last_updated": "2013-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NH",
"license": "NH323",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30356560",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2210633",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "0907885Y0NH02",
"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 Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.