Active NPI
Thomas Provost, D.O.
- Anesthesiology Physician
- Keene, NH
National Provider Identifier
1700826203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 10633
- Practice address
- 580 Court St
Anesthesia Dept.
Keene, NH 03431-1715 - Phone
- (603) 354-5454
- Fax
- (603) 354-5428
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 10633 | NH | |
| Interventional Pain Medicine Physician | 208VP0014X | 10633 | NH | |
| Anesthesiology Physician | 207L00000X | 10633 | NH | Primary |
Addresses
Primary practice location
580 Court St
Anesthesia Dept.
Keene, NH 03431-1715
Mailing address
PO Box 845614
Cheshire Anesthesia
Boston, MA 02284-5614
Phone (800) 720-1664
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30220464 | Medicaid | NH | |
| 050071165 | Other | RAILROAD MEDICARE |
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
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585785600000",
"number": "1700826203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 845614",
"address_2": "CHESHIRE ANESTHESIA",
"city": "BOSTON",
"state": "MA",
"postal_code": "022845614",
"telephone_number": "800-720-1664",
"fax_number": "207-753-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "580 COURT ST",
"address_2": "ANESTHESIA DEPT.",
"city": "KEENE",
"state": "NH",
"postal_code": "034311715",
"telephone_number": "603-354-5454",
"fax_number": "603-354-5428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROVOST",
"first_name": "THOMAS",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2020-04-02",
"certification_date": "2020-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "NH",
"license": "10633",
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "NH",
"license": "10633",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NH",
"license": "10633",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30220464",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "050071165",
"state": null
}
],
"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 Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.