Individual provider Active NPI

Nicholas Peter Kershbaumer, APRN

  • Primary Care Nurse Practitioner
  • Amherst, NH
National Provider Identifier
1821519836
Registry record updated Jun 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
067955-23 Issued in NH
Practice address
199 Route 101
Meeting Place Plaza
Amherst, NH 03031
Phone
(603) 249-3000
NPI assigned
Jun 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 067955-23 NH Primary

Addresses

Primary practice location

199 Route 101
Meeting Place Plaza
Amherst, NH 03031

Mailing address

PO Box 1220
Amherst, NH 03031-1220
Phone (603) 249-3000

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
I20171002001236 NH Practitioner - Nurse Practitioner 6103191135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elliot Physicians NetworkGroup PAC ID 6406743988, 78 clinicians

Practice addresses (Care Compare)

20 Chambers Dr
Hooksett, NH 03106-1981

275 Mammoth Rd
Manchester, NH 03109-4133

Hospital & facility affiliations

  • Vna Home Health and Hospice Services, Inc Home health agency, Manchester, NH, CCN 307003
  • Elliot Hospital Hospital, Manchester, NH, CCN 300012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
067955-23NHMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Physicians Network CurrentSince Aug 31, 2017 Accepting new patients
Elliot Physicians Network Past Accepting new patients
Elliot Professional Services PastSince May 31, 2018 Accepting new patients

Locations

25 S River Rd
Bedford, NH 03110
Phone (603) 626-4392

20 Chambers Dr
Ste 2200
Hooksett, NH 03106
Phone (603) 641-5386

20 Chambers Dr
Ste 1200
Hooksett, NH 03106
Phone (603) 624-8652

275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498694400000",
    "number": "1821519836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1220",
            "city": "AMHERST",
            "state": "NH",
            "postal_code": "030311220",
            "telephone_number": "603-249-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 ROUTE 101",
            "address_2": "MEETING PLACE PLAZA",
            "city": "AMHERST",
            "state": "NH",
            "postal_code": "03031",
            "telephone_number": "603-249-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHBAUMER",
        "first_name": "NICHOLAS",
        "middle_name": "PETER",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-29",
        "last_updated": "2017-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NH",
            "license": "067955-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, NH

Sources for this page

Verify at the official NPI Registry.