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Organization Active NPI

Littleton Hospital Association

  • Rural Health Clinic/Center
  • Littleton, NH
National Provider Identifier
1811944523
Registry record updated Feb 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LITTLETON HOSPITAL ASSOCIATION
Practice address
580 Saint Johnsbury Rd
Littleton, NH 03561-3437
Phone
(603) 444-7070
Fax
(603) 444-4075
NPI assigned
May 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2016

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

Authorized official

Name
Andrew Majka
Title
Cfo
Phone
(603) 444-9504

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

580 Saint Johnsbury Rd
Littleton, NH 03561-3437

Mailing address

PO Box 160
Littleton, NH 03561
Phone (603) 259-7627

Other identifiers 3

IdentifierTypeStateIssuer
0303988MedicaidVT
30518645MedicaidNH
70008987MedicaidNH

Other names 1

  • North Country Primary Care RHC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040322000785 NH Part B Supplier - Clinic/Group Practice 6901796556 Receives reassigned benefits from 241 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Conway, NH; Woodsville, NH; Plymouth, NH; Littleton, NH; Lincoln, NH; Franconia, NH
O20091120000129 NH Part A Provider - Rural Health Clinic 6901796556 Practice locations: Littleton, NH

Rural health clinic certification: CCN 303988

Legal name
LITTLETON HOSPITAL ASSOCIATION
Doing business as
NORTH COUNTRY PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 28, 2009
Last certification
Sep 9, 2022
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Apr 4, 1906 in NH
Enrollment address
580 Saint Johnsbury Rd
Littleton, NH 03561-3437

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

11 Riverglen Ln
Ste 100
Littleton, NH 03561

580 Saint Johnsbury Rd
Ste 14
Littleton, NH 03561

25 Main St
Littleton, NH 03561

680 Saint Johnsbury Rd
Littleton, NH 03561

580 Saint Johnsbury Rd
Ste 25
Littleton, NH 03561
Phone (603) 788-2521

580 Saint Johnsbury Rd
Ste 22
Littleton, NH 03561

580 Saint Johnsbury Rd
Ste 32
Littleton, NH 03561

580 Saint Johnsbury Rd
Ste C
Littleton, NH 03561

12 Yeaton Rd
Ste 4
Plymouth, NH 03264
Phone (603) 536-2270

2000 E Lamar Blvd
Ste 155
Arlington, TX 76006
Phone (817) 542-0217

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Roger Gingue Individual OtherBoard Member Jan 24, 2012
Edward Shanshala Individual OtherBoard Member Jan 1, 2017
Patrick M Fitzpatrick Individual OtherBoard Member Jan 1, 2017
Erin Hennessey Individual OtherBoard Member Jan 28, 2014
Leslie Walker Individual Corporate OfficerController Jan 1, 2017
W-2 Managing Employee Sep 28, 2009
Operational/Managerial ControlController Feb 1, 2017
Nicholas R Marks Individual OtherBoard Member Jan 1, 2017
Laurie Morgan Individual OtherBoard Member Feb 9, 2015
Robert F. Nutter Individual Corporate OfficerPresident Jan 1, 2017
W-2 Managing EmployeePresident Jan 1, 2017
Operational/Managerial ControlPresident Jan 1, 2017
Stephen a Goldberg Individual OtherBoard Member Mar 14, 2017
John P Sauter Individual OtherBoard Member Sep 28, 2009
Steven T Ciampa Individual Corporate Officer Aug 28, 2020
Corporate Director Aug 28, 2020
W-2 Managing Employee Aug 28, 2020
Edward Brewer Individual OtherBoard Member Jan 1, 2017
Deane E Rankin Individual OtherBoard Member Sep 28, 2009
Elizabeth Kunz Individual OtherBoard Member Jan 1, 2017

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Littleton Regional HealthcareLittleton, NH, CCN 30Z302 Hospital Operational/Managerial Control Jan 1, 2010

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 164

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 164

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455753600000",
    "number": "1811944523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "LITTLETON",
            "state": "NH",
            "postal_code": "03561",
            "telephone_number": "603-259-7627",
            "fax_number": "603-259-7561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 SAINT JOHNSBURY RD",
            "city": "LITTLETON",
            "state": "NH",
            "postal_code": "035613437",
            "telephone_number": "603-444-7070",
            "fax_number": "603-444-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLETON HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2016-02-18",
        "status": "A",
        "authorized_official_last_name": "MAJKA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "603-444-9504"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0303988",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30518645",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70008987",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Country Primary Care RHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Littleton, NH

Sources for this page

Verify at the official NPI Registry.