NPIMap

Organization Active NPI

Elliot Professional Services

Doing business as Elliot Pediatric Nephrology and Integrative Medicine

  • Pediatric Nephrology Physician
  • Manchester, NH
National Provider Identifier
1558640912
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
Legal business name
ELLIOT PROFESSIONAL SERVICES
Doing business as
Elliot Pediatric Nephrology and Integrative Medicine
Practice address
275 Mammoth Rd Ste 1
Elliot Pediatric Nephrology & Integrative Medicine
Manchester, NH 03109-4133
Phone
(603) 663-3222
Fax
(603) 663-3229
NPI assigned
Aug 16, 2011
Last updated
Aug 16, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
ELLIOT PROFESSIONAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Authorized official

Name
Richard P Herman
Title
Director of Operations & Finance
Phone
(603) 663-4904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X NU Primary

Addresses

Primary practice location

275 Mammoth Rd Ste 1
Elliot Pediatric Nephrology & Integrative Medicine
Manchester, NH 03109-4133

Mailing address

275 Mammoth Rd Ste 1
Elliot Pediatric Nephrology & Integrative Medicine
Manchester, NH 03109-4133
Phone (603) 663-3222

Other names 1

  • Elliot Pediatric Nephrology and Integrative Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elliot Professional Ser35 organizations share this tax ID, including this one
Part of
Elliot Professional Ser

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1558640912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 MAMMOTH RD STE 1",
            "address_2": "ELLIOT PEDIATRIC NEPHROLOGY & INTEGRATIVE MEDICINE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031094133",
            "telephone_number": "603-663-3222",
            "fax_number": "603-663-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MAMMOTH RD STE 1",
            "address_2": "ELLIOT PEDIATRIC NEPHROLOGY & INTEGRATIVE MEDICINE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031094133",
            "telephone_number": "603-663-3222",
            "fax_number": "603-663-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOT PROFESSIONAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLIOT PROFESSIONAL SERVICES",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS & FINANCE",
        "authorized_official_telephone_number": "603-663-4904"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elliot Pediatric Nephrology and Integrative Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; 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.