Individual provider Active NPI

Teresa M Woodside, FNP-BC

  • Family Nurse Practitioner
  • Keene, NH
National Provider Identifier
1710419874
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
073199-23 Issued in NH
Practice address
580 Court St
Keene, NH 03431-1718
Phone
(603) 354-5400
NPI assigned
Mar 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2278402 MA
Family Nurse Practitioner 363LF0000X 073199-23 NH Primary

Addresses

Primary practice location

580 Court St
Keene, NH 03431-1718

Mailing address

7 Tucker St Unit 73
Pepperell, MA 01463-1552
Phone (207) 400-4062

Other practice location 1

351 Winchester St
Keene, NH 03431-3930
Phone (603) 352-3406

Other identifiers 2

IdentifierTypeStateIssuer
1029936MedicaidVT
3108361MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170414000535 NH Practitioner - Nurse Practitioner 0547546152 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
75.44
Promoting interoperability
100
Improvement activities
40
Cost
72.09

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2278402MAMDFamily Nurse Practitioner
073199-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC Current Accepting new patients
Cheshire Medical Center Current Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince May 8, 2017 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 1, 2019 Accepting new patients
Cheshire Medical Center CurrentSince Jan 1, 2019 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

3 Nashua Rd
Bedford, NH 03110
Phone (603) 472-6700

580 Court St
Keene, NH 03431
Phone (603) 354-5454

590 Court St
Keene, NH 03431
Phone (603) 354-5454

351 Winchester St
Keene, NH 03431
Phone (603) 352-3406

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

Interoperability endpoints

  • Direct secure messaging: twoodside289241@direct.dartmouth-hitchcock.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1710419874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 TUCKER ST UNIT 73",
            "city": "PEPPERELL",
            "state": "MA",
            "postal_code": "014631552",
            "telephone_number": "207-400-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311718",
            "telephone_number": "603-354-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "351 Winchester St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034313930",
            "country_code": "US",
            "telephone_number": "603-352-3406",
            "fax_number": "603-352-3416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODSIDE",
        "first_name": "TERESA",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2278402",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "073199-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029936",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3108361",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.