NPIMap

Organization Active NPI

New England Pediatric Services, LLC

  • Psychologist
  • Bedford, NH
National Provider Identifier
1679967004
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
NEW ENGLAND PEDIATRIC SERVICES, LLC
Practice address
169 S River Rd
Unit 9
Bedford, NH 03110-6971
Phone
(603) 296-5241
Fax
(603) 606-2443
NPI assigned
Mar 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Authorized official

Name
Annie Divello, M.S.,CCC-SLP
Title
Co-Owner
Phone
(603) 296-5241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

169 S River Rd
Unit 9
Bedford, NH 03110-6971

Mailing address

169 S River Rd
Unit 9
Bedford, NH 03110-6971
Phone (603) 296-5241

National Provider Directory

National Provider Directory

Locations

169 S River Rd
Unit 9
Bedford, NH 03110
Phone (603) 296-5241

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427155200000",
    "number": "1679967004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 S RIVER RD",
            "address_2": "UNIT 9",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106971",
            "telephone_number": "603-296-5241",
            "fax_number": "603-606-2443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 S RIVER RD",
            "address_2": "UNIT 9",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106971",
            "telephone_number": "603-296-5241",
            "fax_number": "603-606-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ENGLAND PEDIATRIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-03-24",
        "status": "A",
        "authorized_official_last_name": "DIVELLO",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "603-296-5241",
        "authorized_official_credential": "M.S.,CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; 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.