NPIMap

Individual provider Active NPI

Randall Clark Fenton, M.D.

  • Family Medicine Physician
  • Salem, NH
National Provider Identifier
1629077359
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9962 Issued in NH
Practice address
29 Stiles Rd
Suite 301
Salem, NH 03079-5802
Phone
(603) 870-5452
Fax
(603) 870-5449
NPI assigned
Jul 15, 2005
Last updated
Feb 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9962 NH Primary

Addresses

Primary practice location

29 Stiles Rd
Suite 301
Salem, NH 03079-5802

Mailing address

29 Stiles Rd
Suite 301
Salem, NH 03079-5802
Phone (603) 870-5452

Other identifiers 7

IdentifierTypeStateIssuer
407866OtherUNIFORMED SERVICES FAMILY
66951OtherCIGNA
71838OtherHARVARD PILGRIM HEALTHCAR
J17896OtherBCBS OF MASSACHUSETTS
0100419YPNH01OtherANTHEM BCBS NEW HAMPSHIRE
2637002OtherAETNA
753299OtherTUFTS HEALTHPLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060207000884 NH Practitioner - Family Practice 7214942598 Reassigns benefits to 1 organization
I20130820000934 MA Practitioner - Family Practice 7214942598 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Care of Boston Management CorporationGroup PAC ID 6800787714, 293 clinicians

Practice addresses (Care Compare)

29 Stiles Rd
Suite 301
Salem, NH 03079-5802
Phone (603) 870-5452

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care of Boston Management Corporation CurrentSince Aug 1, 2015 Accepting new patients
Elliot Professional Services Past Accepting new patients
Fenton Family Medicine, PLLC Family Medicine Past Accepting new patients
Valley Regional Medical SVS. Past Accepting new patients
Elliot Physicians Network Family Medicine Past Accepting new patients
Valley Regional Medical Services Past Accepting new patients

Locations

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

29 Stiles Rd
Ste 301
Salem, NH 03079
Phone (603) 870-5452

Interoperability endpoints

  • Direct secure messaging: rfenton123451@direct.bilh.masshiway.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1629077359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 STILES RD",
            "address_2": "SUITE 301",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030795802",
            "telephone_number": "603-870-5452",
            "fax_number": "603-870-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 STILES RD",
            "address_2": "SUITE 301",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030795802",
            "telephone_number": "603-870-5452",
            "fax_number": "603-870-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTON",
        "first_name": "RANDALL",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "9962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIFORMED SERVICES FAMILY",
            "identifier": "407866",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "66951",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "71838",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MASSACHUSETTS",
            "identifier": "J17896",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS NEW HAMPSHIRE",
            "identifier": "0100419YPNH01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2637002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTHPLAN",
            "identifier": "753299",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

Verify at the official NPI Registry.