Active NPI
Beverly J Entwisle, M.D.
- Geriatric Medicine (Internal Medicine) Physician
- Concord, NH
National Provider Identifier
1700889169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 7945
- Practice address
- 250 Pleasant Street
Yeaple Building
Concord, NH 03301 - Phone
- (603) 228-7200
- Fax
- (603) 228-7307
- NPI assigned
- May 31, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 7945 | NH | Primary |
Addresses
Primary practice location
250 Pleasant Street
Yeaple Building
Concord, NH 03301
Mailing address
250 Pleasant Street
Yeaple Building
Concord, NH 03301
Phone (603) 228-7200
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| H005016 | Other | NH | TRICARE ID# |
| 3016717 | Other | NH | AETNA ID# |
| 25526 | Other | NH | CIGNA ID# |
| 30002613 | Medicaid | NH | |
| 371528 | Other | NH | MVP ID# |
| E14790 | Other | NH | HARVARD PILGRIM ID# |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7945 | NH | MD | Geriatric Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1700889169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 PLEASANT STREET",
"address_2": "YEAPLE BUILDING",
"city": "CONCORD",
"state": "NH",
"postal_code": "03301",
"telephone_number": "603-228-7200",
"fax_number": "603-228-7307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 PLEASANT STREET",
"address_2": "YEAPLE BUILDING",
"city": "CONCORD",
"state": "NH",
"postal_code": "03301",
"telephone_number": "603-228-7200",
"fax_number": "603-228-7307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENTWISLE",
"first_name": "BEVERLY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-05-31",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "NH",
"license": "7945",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE ID#",
"identifier": "H005016",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA ID#",
"identifier": "3016717",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA ID#",
"identifier": "25526",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30002613",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP ID#",
"identifier": "371528",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM ID#",
"identifier": "E14790",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.