Individual provider Active NPI

Katelyn Isherwood

  • Family Medicine Physician
  • Derry, NH
National Provider Identifier
1639890502
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
265702 Issued in MA
Practice address
44 Birch St Ste 305
Derry, NH 03038-2752
Phone
(603) 845-1966
NPI assigned
Sep 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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 265702 MA Primary

Addresses

Primary practice location

44 Birch St Ste 305
Derry, NH 03038-2752

Mailing address

44 Birch St Ste 305
Derry, NH 03038-2752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250623002927 NH Practitioner - Nurse Practitioner 7113439498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
265702MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
JSB Wellness, LLC Family Medicine CurrentSince Mar 1, 2024 Accepting new patients
Steward Medical Group, Inc PastSince Sep 1, 2022 Accepting new patients
Revere Medical of Massachusetts, PC Family Medicine PastSince Sep 1, 2022 Accepting new patients

Locations

997 Osgood St
North Andover, MA 01845
Phone (781) 690-6402

Organizations & group practices 3

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": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1639890502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 BIRCH ST STE 305",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030382752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 BIRCH ST STE 305",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030382752",
            "telephone_number": "603-845-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHERWOOD",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-08",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "265702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

Verify at the official NPI Registry.