Jack Gavin, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

047435-23-03 Issued in NH

Practice address

314 S Main St
Concord, NH 03301-3468

Phone

(603) 568-7867

Fax

(603) 410-6682

NPI assigned

Dec 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Elliot Professional Services

  • Internal Medicine Physician
  • Manchester, NH
  • NPI 1285627935
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1548329931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 NORWICH ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012216",
            "telephone_number": "603-568-7867",
            "fax_number": "603-410-6682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 S MAIN ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033013468",
            "telephone_number": "603-568-7867",
            "fax_number": "603-410-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "JACK",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "047435-23-03",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "047435-23-08",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30342516",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellyn Whelan Gaudet, APRN
• Meghan Gauss
• Amy Gauthier
• Lesley Gauthier
• Elizabeth Ann Gavin, ARNP
• Heather Gaylord, MS, LCMHC
• David P Gazzola, PT
• Amanda Geary, OD
• Dominic F. Geffken, M.D.
• Julaine E Geldermann, DPT

• Family Nurse Practitioner in Concord, NH
• Providers in Concord, NH by specialty
• Family Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.