Active NPI
Ernst M Oidtmann, M.D.
- Family Medicine Physician
- Lebanon, NH
National Provider Identifier
1538201009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 6030
- Practice address
- 252 Mechanic St
Lebanon, NH 03766-2613 - Phone
- (603) 448-1941
- Fax
- (603) 448-6059
- NPI assigned
- Feb 13, 2007
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 6030 | NH | Primary |
Addresses
Primary practice location
252 Mechanic St
Lebanon, NH 03766-2613
Mailing address
252 Mechanic St
Lebanon, NH 03766-2613
Phone (603) 448-1941
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000458 | Medicaid | NH | |
| 00006881 | Other | NH | VT BLUE SHIELD |
| 8744837 | Other | NH | CIGNA |
| B86027 | Other | NH | HARVARD PILGRIM |
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": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185235200000",
"number": "1538201009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "252 MECHANIC ST",
"city": "LEBANON",
"state": "NH",
"postal_code": "037662613",
"telephone_number": "603-448-1941",
"fax_number": "603-448-6059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "252 MECHANIC ST",
"city": "LEBANON",
"state": "NH",
"postal_code": "037662613",
"telephone_number": "603-448-1941",
"fax_number": "603-448-6059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OIDTMANN",
"first_name": "ERNST",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NH",
"license": "6030",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0000458",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VT BLUE SHIELD",
"identifier": "00006881",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "8744837",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "B86027",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.