Organization Active NPI

Catholic Medical Center Physician Practice Associates

Doing business as Granite State Internal Medicine

  • Internal Medicine Physician
  • Manchester, NH
National Provider Identifier
1780862912
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CATHOLIC MEDICAL CENTER PHYSICIAN PRACTICE ASSOCIATES
Doing business as
Granite State Internal Medicine
Practice address
53 Goffstown Rd
Manchester, NH 03102-2737
Phone
(603) 669-7162
Fax
(603) 206-1378
NPI assigned
Feb 11, 2008
Last updated
Feb 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Andre Therrien
Title
Controller
Phone
(603) 663-8779

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NH Primary

Addresses

Primary practice location

53 Goffstown Rd
Manchester, NH 03102-2737

Mailing address

53 Goffstown Rd
Manchester, NH 03102-2737
Phone (603) 669-7162

Other names 1

  • Granite State Internal Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

53 Goffstown Rd
Manchester, NH 03102
Phone (603) 206-1380

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1780862912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 GOFFSTOWN RD",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031022737",
            "telephone_number": "603-669-7162",
            "fax_number": "603-206-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 GOFFSTOWN RD",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031022737",
            "telephone_number": "603-669-7162",
            "fax_number": "603-206-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC MEDICAL CENTER PHYSICIAN PRACTICE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "THERRIEN",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "603-663-8779"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granite State Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 11, 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.