Speare Memorial Hospital
Organization Active NPI Orthopaedic Surgery Physician · Plymouth, NH
NPI 1528213428 · NPPES record last updated Apr 11, 2018
Key facts
- NPI
- 1528213428
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- SPEARE MEMORIAL HOSPITAL
- Practice address
- 103 Boulder Point Dr
Plymouth, NH 03264-3168 - Phone
- (603) 536-1565
- Fax
- (603) 536-1200
- NPI assigned
- Nov 20, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- SPEARE MEMORIAL HOSPITAL
Authorized official
- Name
- Michelle L McEwen
- Title
- President/Ceo
- Phone
- (603) 536-1120
Other NPIs with the same Medicare PAC ID 11
Practitioners 58
-
Yaroslav Basyuk, MD
-
Patrick J Casey, MD
-
Ryan Killian Duffy, M.D.
-
Lance J Klingler, MD
-
Anton Michael Kurtz, M.D.
-
Clifford M Levy, MD
-
Ross Abraham McEntarfer, M.D.
-
Kristina Marie Foss, FNP
-
Fady E Abou Rizk, MD
-
Reda Benhorma, MD
-
Adam M Boise, APRN
-
Eric M Bonnem, MD
-
Jamison Forrest Costello, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090210000333 | NH | Part B Supplier - Clinic/Group Practice | 1153318068 |
Receives reassigned benefits from 15 practitioners Practice locations: Plymouth, NH |
National Provider Directory
- Part of
- Sceva Speare Pathology
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
103 Boulder Point Dr
Plymouth, NH 03264-3168
Mailing address
16 Hospital Rd
Plymouth, NH 03264-1126
Phone (603) 238-2204
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009161 | Medicaid | VT | |
| 3077000 | Medicaid | NH |
Other providers in Plymouth, NH
- Speare Memorial Hospital
- Speare Memorial Hospital
- Speare Memorial Hospital
- Speare Memorial Hospital
- Speare Memorial Hospital
- Speare Memorial Hospital
- Speare Memorial Hospital
- Speare Memorial Hospital
- Speare Memorial Hospital
- Speare Memorial Hospital
All providers in Plymouth, NH · Orthopaedic Surgery Physician in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.