Individual provider Active NPI

Christy Marie Gullage, FNP-BC

  • Family Nurse Practitioner
  • Keene, NH
National Provider Identifier
1760100382
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
059036-23 Issued in NH
Practice address
351 Winchester St
Keene, NH 03431-3930
Phone
(603) 352-3406
Fax
(603) 352-3416
NPI assigned
Aug 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 059036-23 NH Primary

Addresses

Primary practice location

351 Winchester St
Keene, NH 03431-3930

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Other practice location 1

458 Old Street Rd Ste 200
Peterborough, NH 03458-1216
Phone (603) 924-2144

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
I20221014001221 NH Practitioner - Nurse Practitioner 7214303346 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Monadnock Community Hospital Current Accepting new patients
Convenientmd - FFS UC LLC Current Accepting new patients

Locations

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

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

551 Meadow St
Littleton, NH 03561
Phone (603) 761-3660

452 Old Street Rd
Peterborough, NH 03458
Phone (603) 924-4699

111 New Hampshire Ave
Portsmouth, NH 03801

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

125 Indian Rock Rd
Windham, NH 03087
Phone (603) 890-6330

Organizations & group practices 5

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": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1760100382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 WINCHESTER ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034313930",
            "telephone_number": "603-352-3406",
            "fax_number": "603-352-3416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "458 Old Street Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Peterborough",
            "state": "NH",
            "postal_code": "034581216",
            "country_code": "US",
            "telephone_number": "603-924-2144",
            "fax_number": "603-924-3993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GULLAGE",
        "first_name": "CHRISTY",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "059036-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.