Active NPI
Jennifer Gaudet, ATC
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Manchester, NH
National Provider Identifier
1558862292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- License
- 1275
- Practice address
- 35 Kosciuszko St
Manchester, NH 03101-1608 - Phone
- (603) 627-9728
- NPI assigned
- Feb 27, 2018
- Last updated
- Feb 27, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Sports Medicine (Physical Medicine & Rehabilitation) Physician | 2081S0010X | 1275 | NH | Primary |
Addresses
Primary practice location
35 Kosciuszko St
Manchester, NH 03101-1608
Mailing address
6 Lisbon LN
Nashua, NH 03060-5093
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2394460 | Other | PROLIABILITY |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1275 | NH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519689600000",
"number": "1558862292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 LISBON LN",
"city": "NASHUA",
"state": "NH",
"postal_code": "030605093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 KOSCIUSZKO ST",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031011608",
"telephone_number": "603-627-9728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUDET",
"first_name": "JENNIFER",
"name_prefix": "Miss",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-27",
"last_updated": "2018-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "2081S0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Sports Medicine",
"state": "NH",
"license": "1275",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROLIABILITY",
"identifier": "2394460",
"state": null
}
],
"endpoints": [],
"other_names": []
}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 Feb 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.