NPIMap

Organization Active NPI

Elliot Professional Services

Doing business as Greater Pawtuckaway Imaging

  • Diagnostic Radiology Physician
  • Raymond, NH
National Provider Identifier
1780650457
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ELLIOT PROFESSIONAL SERVICES
Doing business as
Greater Pawtuckaway Imaging
Practice address
15 Freetown Rd
Greater Pawtuckaway Imaging
Raymond, NH 03077-2358
Phone
(603) 895-8000
Fax
(603) 895-8099
NPI assigned
Feb 23, 2006
Last updated
Jul 8, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
ELLIOT PROFESSIONAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Authorized official

Name
Richard P. Herman
Title
Director of Operations & Finance
Phone
(603) 663-4904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

15 Freetown Rd
Greater Pawtuckaway Imaging
Raymond, NH 03077-2358

Mailing address

15 Freetown Rd
Greater Pawtuckaway Imaging
Raymond, NH 03077-2358
Phone (603) 895-8000

Other identifiers 8

IdentifierTypeStateIssuer
30812254MedicaidNH
3207928OtherNHAETNA GRP
626440OtherNHHPHC GRP
15Y002260NH02OtherNHANTHEM GRP ACES
601463704OtherNHW/C DOL GRP
667221OtherNHCIGNA GRP
696696OtherNHTUFTS GRP
P00009327OtherNHRR MEDICARE GRP

Other names 1

  • Greater Pawtuckaway Imaging Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elliot Professional Ser35 organizations share this tax ID, including this one
Part of
Elliot Professional Ser

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Locations

15 Freetown Rd
Raymond, NH 03077
Phone (603) 895-8000

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1780650457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 FREETOWN RD",
            "address_2": "GREATER PAWTUCKAWAY IMAGING",
            "city": "RAYMOND",
            "state": "NH",
            "postal_code": "030772358",
            "telephone_number": "603-895-8000",
            "fax_number": "603-895-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FREETOWN RD",
            "address_2": "GREATER PAWTUCKAWAY IMAGING",
            "city": "RAYMOND",
            "state": "NH",
            "postal_code": "030772358",
            "telephone_number": "603-895-8000",
            "fax_number": "603-895-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOT PROFESSIONAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLIOT PROFESSIONAL SERVICES",
        "enumeration_date": "2006-02-23",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS & FINANCE",
        "authorized_official_telephone_number": "603-663-4904"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30812254",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GRP",
            "identifier": "3207928",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC GRP",
            "identifier": "626440",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GRP ACES",
            "identifier": "15Y002260NH02",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "W/C DOL GRP",
            "identifier": "601463704",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GRP",
            "identifier": "667221",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS GRP",
            "identifier": "696696",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GRP",
            "identifier": "P00009327",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Pawtuckaway Imaging",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raymond, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.