Active NPI
Douglas G Merrill, MD, MBA
- Pain Medicine (Anesthesiology) Physician
- Lebanon, NH
National Provider Identifier
1710954219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 14661
- Practice address
- 1 Medical Center Dr
Department of Anesthesia
Lebanon, NH 03756-1000 - Phone
- (603) 650-5922
- Fax
- (603) 650-8980
- NPI assigned
- Mar 2, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 14661 | NH | Primary |
Addresses
Primary practice location
1 Medical Center Dr
Department of Anesthesia
Lebanon, NH 03756-1000
Mailing address
1 Medical Center Dr
Department of Anesthesia
Lebanon, NH 03756-1000
Phone (603) 650-5922
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0748467 | Medicaid | IA | |
| 1017029 | Medicaid | VT | |
| 8255556 | Medicaid | WA | |
| 29542 | Other | IA | WELLMARK BCBS |
| 30209185 | Medicaid | NH | |
| 5531ME | Other | WA | INDIVIDUAL BLUE SHIELD |
| 050077267 | Other | WA | RAIL ROAD 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
- Master of Business Administration, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14661 | NH | MD | Pain Medicine (Anesthesiology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312156800000",
"number": "1710954219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"address_2": "DEPARTMENT OF ANESTHESIA",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-5922",
"fax_number": "603-650-8980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL CENTER DR",
"address_2": "DEPARTMENT OF ANESTHESIA",
"city": "LEBANON",
"state": "NH",
"postal_code": "037561000",
"telephone_number": "603-650-5922",
"fax_number": "603-650-8980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRILL",
"first_name": "DOUGLAS",
"middle_name": "G",
"credential": "MD, MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-02",
"last_updated": "2011-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "NH",
"license": "14661",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0748467",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1017029",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8255556",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS",
"identifier": "29542",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30209185",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL BLUE SHIELD",
"identifier": "5531ME",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "050077267",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.