Active NPI
Caroline Mandeville, OD
- Optometrist
- Salem, NH
National Provider Identifier
1689417404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1205
- Practice address
- 10 S Village Dr Ste 420
Salem, NH 03079-3317 - Phone
- (603) 893-5288
- NPI assigned
- Jun 18, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1205 | NH | Primary |
Addresses
Primary practice location
10 S Village Dr Ste 420
Salem, NH 03079-3317
Mailing address
11 Shoreline Dr
Hudson, NH 03051-3271
Phone (914) 582-3441
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1205 | NH | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718755200000",
"number": "1689417404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 SHORELINE DR",
"city": "HUDSON",
"state": "NH",
"postal_code": "030513271",
"telephone_number": "914-582-3441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 S VILLAGE DR STE 420",
"city": "SALEM",
"state": "NH",
"postal_code": "030793317",
"telephone_number": "603-893-5288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDEVILLE",
"first_name": "CAROLINE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-18",
"last_updated": "2024-06-19",
"certification_date": "2024-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "NH",
"license": "1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.