Carli Vincent, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

31003 Issued in NH

Practice address

81 Hall St
Concord, NH 03301-3420

Phone

(603) 537-1300

Fax

(603) 415-9993

NPI assigned

Mar 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carli Wallace Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Connecticut School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, 1,992 clinicians

Derry Medical Center, PAGroup PAC ID 5294711768, 98 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Concord Hospital Hospital, Concord, NH, CCN 300001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Derry Medical Center, PA

  • Family Medicine Physician
  • Derry, NH
  • NPI 1922030493

  Family Medicine, NH

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Concord Hospital, Inc.

  • General Acute Care Hospital
  • Concord, NH
  • NPI 1215988530

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1760069918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14B TSIENNETO RD",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381647",
            "telephone_number": "603-537-1300",
            "fax_number": "603-415-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HALL ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033013420",
            "telephone_number": "603-537-1300",
            "fax_number": "603-415-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "CARLI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "31003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLI",
            "last_name": "WALLACE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dina Veytsman, DNP, APRN, PMHNP-BC
• Victory Distributors LLC
• Victory Distributors, LLC
• Robert Clyde Vidaver, M.D.
• Robert M Vidaver, MD
• Visavis Health Care Medical Group of NH LLC
• Ashley Vittum, APRN
• Elisa Vocca, PA-C
• George Christian Vorys, MD
• Elizabeth Vreeland, RN

• All providers in Concord, NH
• Family Medicine Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.