Individual provider Active NPI

Mary Grace Manter

  • Physical Therapy Assistant
  • Goffstown, NH
National Provider Identifier
1649578121
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
0914 Issued in NH
Practice address
223B Black Brook Rd Ste 2
Goffstown, NH 03045-2901
Phone
(603) 703-2569
Fax
(603) 894-1113
NPI assigned
Mar 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0914 NH Primary

Addresses

Primary practice location

223B Black Brook Rd Ste 2
Goffstown, NH 03045-2901

Mailing address

223B Black Brook Rd Ste 2
Goffstown, NH 03045-2901
Phone (603) 703-2569

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

LicenseStateTypeSpecialty
0914NHMDRenal Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1649578121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223B BLACK BROOK RD STE 2",
            "city": "GOFFSTOWN",
            "state": "NH",
            "postal_code": "030452901",
            "telephone_number": "603-703-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223B BLACK BROOK RD STE 2",
            "city": "GOFFSTOWN",
            "state": "NH",
            "postal_code": "030452901",
            "telephone_number": "603-703-2569",
            "fax_number": "603-894-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTER",
        "first_name": "MARY",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-07",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NH",
            "license": "0914",
            "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 Nov 22, 2024; 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.