Active NPI
Paul S. Spivack, MD
- Pediatrics Physician
- Bedford, NH
National Provider Identifier
1518900190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 7629
- Practice address
- 25 S River Rd
Bedford, NH 03110-6708 - Phone
- (603) 695-2572
- Fax
- (603) 695-2727
- NPI assigned
- Jun 13, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 7629 | NH | Primary |
Addresses
Primary practice location
25 S River Rd
Bedford, NH 03110-6708
Mailing address
25 S River Rd
Bedford, NH 03110-6708
Phone (603) 695-2572
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30001972 | 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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309478400000",
"number": "1518900190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 S RIVER RD",
"city": "BEDFORD",
"state": "NH",
"postal_code": "031106708",
"telephone_number": "603-695-2572",
"fax_number": "603-695-2727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 S RIVER RD",
"city": "BEDFORD",
"state": "NH",
"postal_code": "031106708",
"telephone_number": "603-695-2572",
"fax_number": "603-695-2727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPIVACK",
"first_name": "PAUL",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2011-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NH",
"license": "7629",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30001972",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bedford, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.