Bedford Pediatrics, P.a.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

Legal business name

BEDFORD PEDIATRICS, P.A.

Practice address

360 Route 101
Unit 7B
Bedford, NH 03110-5030

Phone

(603) 471-0831

Fax

(603) 471-0890

NPI assigned

Mar 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kermit Brunelle, M.D.

Title

President

Phone

(603) 471-0831

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528184439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 ROUTE 101",
            "address_2": "UNIT 7B",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031105030",
            "telephone_number": "603-471-0831",
            "fax_number": "603-471-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 ROUTE 101",
            "address_2": "UNIT 7B",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031105030",
            "telephone_number": "603-471-0831",
            "fax_number": "603-471-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEDFORD PEDIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUNELLE",
        "authorized_official_first_name": "KERMIT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-471-0831",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30210849",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bedford Geriatric Physical Therapy, LLC
• Bedford Hills SNF Opco LLC (Bedford Hills Center)
• Bedford Internal Medicine PA
• Bedford Medical Imaging Center, LLC
• Bedford Nursing & Rehab Services, LLC (Bedford Nursing & Rehabilitation Center)
• Bedford Pharmacy Corp.
• Bedford Podiatry Group PC
• Bedford School District
• Bedford SNF Opco LLC
• Bedford Village Dental PLLC (Bedford Village Dental)

• Pediatric Adolescent Medicine Physician in Bedford, NH
• Providers in Bedford, NH by specialty
• Pediatric Adolescent Medicine Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.