Active NPI
Brian R Fradette, D.P.M.
- Foot & Ankle Surgery Podiatrist
- Derry, NH
National Provider Identifier
1679594592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- NH0149
- Practice address
- 6 Tsienneto Rd
Suite 303
Derry, NH 03038-1584 - Phone
- (603) 432-2508
- Fax
- (603) 432-2008
- NPI assigned
- Jul 23, 2006
- Last updated
- Jun 3, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | NH0149 | NH | Primary |
Addresses
Primary practice location
6 Tsienneto Rd
Suite 303
Derry, NH 03038-1584
Mailing address
6 Tsienneto Rd
Suite 303
Derry, NH 03038-1584
Phone (603) 432-2508
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80488249 | Medicaid | NH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| NH0149 | NH | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307059200000",
"number": "1679594592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 TSIENNETO RD",
"address_2": "SUITE 303",
"city": "DERRY",
"state": "NH",
"postal_code": "030381584",
"telephone_number": "603-432-2508",
"fax_number": "603-432-2008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 TSIENNETO RD",
"address_2": "SUITE 303",
"city": "DERRY",
"state": "NH",
"postal_code": "030381584",
"telephone_number": "603-432-2508",
"fax_number": "603-432-2008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRADETTE",
"first_name": "BRIAN",
"middle_name": "R",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-23",
"last_updated": "2011-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NH",
"license": "NH0149",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80488249",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Derry, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.