Mascoma Street Inpatient Services LLC

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

Legal business name

MASCOMA STREET INPATIENT SERVICES LLC

Practice address

10 Alice Peck Day Dr
Lebanon, NH 03766-2900

Phone

(469) 401-2386

NPI assigned

Jul 25, 2016

Organization subpart

No

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

Authorized official

Name

Russell Harris, MD

Title

President

Phone

(954) 838-2371

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1780137802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD STE 1600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401374",
            "telephone_number": "954-838-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 ALICE PECK DAY DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037662900",
            "telephone_number": "469-401-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASCOMA STREET INPATIENT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-25",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-838-2371",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Hitchcock Memorial Hospital
• Mary Hitchcock Memorial Hospital
• Mary Hitchcock Memorial Hospital
• Mascoma Dental Associates,PLLC
• Mascoma Eyecare
• Christopher Michael Mashiak, MD
• Linda Mason, LICSW
• Peter A Mason, MD
• Deena M Masten, APRN
• Gabriel Masters

• Hospitalist Physician in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Hospitalist Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.