Individual provider Active NPI

Kelly Dawn Piche, P.T

  • Physical Therapist
  • Goffstown, NH
National Provider Identifier
1578711180
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3260 Issued in NH
Practice address
817 Back Mountain Rd
Goffstown, NH 03045-2107
Phone
(617) 721-7453
NPI assigned
Sep 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3260 NH Primary

Addresses

Primary practice location

817 Back Mountain Rd
Goffstown, NH 03045-2107

Mailing address

817 Back Mountain Rd
Goffstown, NH 03045-2107
Phone (617) 721-7453

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

State licenses

LicenseStateTypeSpecialty
3260NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Granite State Physical Therapy Hooksett PLLC Physical Therapist PastSince Nov 13, 2018 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1578711180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 BACK MOUNTAIN RD",
            "city": "GOFFSTOWN",
            "state": "NH",
            "postal_code": "030452107",
            "telephone_number": "617-721-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 BACK MOUNTAIN RD",
            "city": "GOFFSTOWN",
            "state": "NH",
            "postal_code": "030452107",
            "telephone_number": "617-721-7453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICHE",
        "first_name": "KELLY",
        "middle_name": "DAWN",
        "credential": "P.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-08",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "3260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goffstown, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; 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.