Londonderry Gastroenterology Associates PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

6919 Issued in NH

Legal business name

LONDONDERRY GASTROENTEROLOGY ASSOCIATES PA

Practice address

1B Commons Dr
Unit 9a
Londonderry, NH 03053-3441

Phone

(603) 818-4712

Fax

(603) 421-6899

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark Kenneth Detweiler, M.D.NPI 1548344583

Title

Physician

Phone

(603) 818-4712

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Tax ID family

Londonderry Gastroenterology Associates PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Londonderry Gastroenterology Associates PA

  • Gastroenterology Physician
  • Derry, NH
  • NPI 1851782312
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9677/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Mark Kenneth Detweiler, M.D.

  • Specialist
  • Londonderry, NH
  • NPI 1548344583
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1851318281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COMMONS DR # B",
            "address_2": "UNIT 9A",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533441",
            "telephone_number": "603-818-4712",
            "fax_number": "603-421-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1B COMMONS DR",
            "address_2": "UNIT 9A",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533441",
            "telephone_number": "603-818-4712",
            "fax_number": "603-421-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONDONDERRY GASTROENTEROLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "DETWEILER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "603-818-4712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NH",
            "license": "6919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80001279",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liz Neville
• Natalie Locke, LCMHC
• Cyrilla Ann Lombardi, DMD
• John L. Lombardi, DMD
• Londonderry Dentistry & Implants, PLLC
• Londonderry Internal Medicine Associates, P.C.
• Londonderry Nurse Practitionerswholehealth Consultants
• Londonderry Oral Surgery PLLC
• Londonderry Pediatrics, PA
• Londonderry School District

• Specialist in Londonderry, NH
• Providers in Londonderry, NH by specialty
• Specialist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.