Individual provider Active NPI

Tabitha Dreckmann, LPN

  • Psychiatric/Mental Health Registered Nurse
  • Manchester, NH
National Provider Identifier
1730722869
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
017965-22 Issued in NH
Practice address
401 Cypress St
Manchester, NH 03103-3628
Phone
(603) 668-4111
NPI assigned
Oct 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 054657-24 NH
Psychiatric/Mental Health Registered Nurse 163WP0808X 19105551 NH
Psychiatric/Mental Health Registered Nurse 163WP0808X 017965-22 NH Primary

Addresses

Primary practice location

401 Cypress St
Manchester, NH 03103-3628

Mailing address

2 Wall St Ste 300
Manchester, NH 03101-1518
Phone (603) 668-4111

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
017965-22NHMDPsychiatric/Mental Health Registered Nurse
054657-24NHMDPsychiatric/Mental Health Registered Nurse
19105551NHMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The Mental Health Center of Greater Manchester PastSince Oct 27, 2019 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": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1730722869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WALL ST STE 300",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011518",
            "telephone_number": "603-668-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CYPRESS ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033628",
            "telephone_number": "603-668-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRECKMANN",
        "first_name": "TABITHA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NH",
            "license": "054657-24",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NH",
            "license": "19105551",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NH",
            "license": "017965-22",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.