Active NPI
Elizabeth A Shea, MD
- Pediatrics Physician
- Peterborough, NH
National Provider Identifier
1730129669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 12079
- Practice address
- 454 Old Street Rd
Suite 106
Peterborough, NH 03458-1200 - Phone
- (603) 924-7101
- Fax
- (603) 924-3569
- NPI assigned
- Jun 8, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 12079 | NH | Primary |
Addresses
Primary practice location
454 Old Street Rd
Suite 106
Peterborough, NH 03458-1200
Mailing address
452 Old Street Rd
Peterborough, NH 03458-1263
Phone (603) 924-7191
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30203795 | Medicaid | NH |
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 |
|---|---|---|---|
| 12079 | NH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monadnock Community Hospital | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730129669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "452 OLD STREET RD",
"city": "PETERBOROUGH",
"state": "NH",
"postal_code": "034581263",
"telephone_number": "603-924-7191",
"fax_number": "603-924-3569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "454 OLD STREET RD",
"address_2": "SUITE 106",
"city": "PETERBOROUGH",
"state": "NH",
"postal_code": "034581200",
"telephone_number": "603-924-7101",
"fax_number": "603-924-3569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEA",
"first_name": "ELIZABETH",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NH",
"license": "12079",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30203795",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peterborough, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.