Organization Active NPI

Change With More Ease LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lebanon, NH
National Provider Identifier
1831865153
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CHANGE WITH MORE EASE LLC
Practice address
20 W Park St Ste 420
Lebanon, NH 03766-1322
Phone
(603) 667-6743
Fax
(866) 309-2937
NPI assigned
Aug 17, 2021
Last updated
Aug 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Authorized official

Name
Mary Ford, PMHNPNPI 1518632124
Title
Nurse Practitioner
Phone
(603) 667-6743

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

20 W Park St Ste 420
Lebanon, NH 03766-1322

Mailing address

329 Murray Hill Dr
Montpelier, VT 05602-4216
Phone (603) 667-6743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211005001122 NH Part B Supplier - Clinic/Group Practice 6901204064 Receives reassigned benefits from 1 practitioner
Practice locations: Lebanon, NH

National Provider Directory

National Provider Directory

Locations

20 W Park St
Ste 420
Lebanon, NH 03766
Phone (603) 667-6743

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1831865153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 MURRAY HILL DR",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056024216",
            "telephone_number": "603-667-6743",
            "fax_number": "866-309-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W PARK ST STE 420",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661322",
            "telephone_number": "603-667-6743",
            "fax_number": "866-309-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE WITH MORE EASE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "603-667-6743",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.