Individual provider Active NPI

Jonathan P Pattavina, D.P.M.

  • Podiatrist
  • Keene, NH
National Provider Identifier
1669490793
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0263 Issued in NH
Practice address
61 Summer St
Keene, NH 03431-3318
Phone
(603) 352-2944
Fax
(603) 355-2273
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0263 NH Primary

Addresses

Primary practice location

61 Summer St
Keene, NH 03431-3318

Mailing address

61 Summer St
Keene, NH 03431-3318
Phone (603) 352-2944

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
0263NHMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254960000000",
    "number": "1669490793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 SUMMER ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313318",
            "telephone_number": "603-352-2944",
            "fax_number": "603-355-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 SUMMER ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313318",
            "telephone_number": "603-352-2944",
            "fax_number": "603-355-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTAVINA",
        "first_name": "JONATHAN",
        "middle_name": "P",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2009-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NH",
            "license": "0263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; 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.