Individual provider Active NPI

Carolyn M Guillette, PAC

  • Surgical Physician Assistant
  • Exeter, NH
National Provider Identifier
1619934932
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0327 Issued in NH
Practice address
3 Alumni Dr Ste 204
Exeter, NH 03833-2122
Phone
(603) 658-1277
Fax
(603) 658-1278
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0327 NH Primary

Addresses

Primary practice location

3 Alumni Dr Ste 204
Exeter, NH 03833-2122

Mailing address

7 Holland Way FL 1
Exeter, NH 03833-2997
Phone (603) 658-1277

Other identifiers 1

IdentifierTypeStateIssuer
3076083MedicaidNH

Other names 1

  • Carolyn M Pappas Former name

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0327NHMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1619934932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 HOLLAND WAY FL 1",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332997",
            "telephone_number": "603-658-1277",
            "fax_number": "603-658-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ALUMNI DR STE 204",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332122",
            "telephone_number": "603-658-1277",
            "fax_number": "603-658-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLETTE",
        "first_name": "CAROLYN",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NH",
            "license": "0327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3076083",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "PAPPAS",
            "middle_name": "M",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Exeter, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.