Active NPI
Steven Roy Grandgeorge, MD
- Allergy Physician
- Manchester, NH
National Provider Identifier
1841236130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- 6661
- Practice address
- 100 Hitchcock Way
Manchester, NH 03104-4125 - Phone
- (603) 695-2500
- Fax
- (603) 695-2562
- NPI assigned
- Jun 22, 2006
- Last updated
- Sep 15, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy Physician | 207KA0200X | 6661 | NH | Primary |
| Pediatric Pulmonology Physician | 2080P0214X | 6661 | NH |
Addresses
Primary practice location
100 Hitchcock Way
Manchester, NH 03104-4125
Mailing address
100 Hitchcock Way
Manchester, NH 03104-4125
Phone (603) 695-2500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30001628 | Medicaid | NH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6661 | NH | MD | Allergy Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1841236130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HITCHCOCK WAY",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031044125",
"telephone_number": "603-695-2500",
"fax_number": "603-695-2562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HITCHCOCK WAY",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031044125",
"telephone_number": "603-695-2500",
"fax_number": "603-695-2562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANDGEORGE",
"first_name": "STEVEN",
"middle_name": "ROY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "NH",
"license": "6661",
"primary": true
},
{
"code": "2080P0214X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Pulmonology",
"state": "NH",
"license": "6661",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30001628",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}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 Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.