Individual provider Active NPI

Frederick S Kelsey, M.D.

  • Internal Medicine Physician
  • Plymouth, NH
National Provider Identifier
1518908151
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
6088 Issued in NH
Practice address
101 Boulder Point Dr
Suite 1
Plymouth, NH 03264
Phone
(603) 536-4000
Fax
(603) 536-4001
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 6088 NH Primary

Addresses

Primary practice location

101 Boulder Point Dr
Suite 1
Plymouth, NH 03264

Mailing address

101 Boulder Point Dr
Suite 1
Plymouth, NH 03264
Phone (603) 536-4000

Other identifiers 2

IdentifierTypeStateIssuer
RE4060OtherNHMEDICARE GROUP
30001184MedicaidNH

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050913000158 NH Practitioner - Internal Medicine 2567495419 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6088NHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-State Health Center CurrentSince Jun 13, 1989 Accepting new patients
Mid-State Health Center Internal Medicine Current Accepting new patients
Mid-State Health Center CurrentSince Jun 13, 1989 Accepting new patients
The Lakes Region Mental Health Center, Inc. PastSince Sep 24, 2009 Accepting new patients

Locations

20 Highland St
Plymouth, NH 03264
Phone (603) 536-3890

101 Boulder Point Dr
Ste 1
Plymouth, NH 03264
Phone (603) 238-3537

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1518908151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BOULDER POINT DR",
            "address_2": "SUITE 1",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "03264",
            "telephone_number": "603-536-4000",
            "fax_number": "603-536-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BOULDER POINT DR",
            "address_2": "SUITE 1",
            "city": "PLYMOUTH",
            "state": "NH",
            "postal_code": "03264",
            "telephone_number": "603-536-4000",
            "fax_number": "603-536-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSEY",
        "first_name": "FREDERICK",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "6088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "RE4060",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30001184",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, NH

Sources for this page

Verify at the official NPI Registry.