NPIMap

Organization Active NPI

Elliot Physicians Network

Doing business as Pediatric Health Associates

  • Pediatrics Physician
  • Manchester, NH
National Provider Identifier
1861483489
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ELLIOT PHYSICIANS NETWORK
Doing business as
Pediatric Health Associates
Practice address
275 Mammoth Rd Ste 1
Pediatric Health Associates
Manchester, NH 03109-4133
Phone
(603) 663-8350
Fax
(603) 663-8399
NPI assigned
Nov 2, 2005
Last updated
Jun 20, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
ELLIOT PHYSICIANS NETWORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Richard P. Herman
Title
Director of Operations & Finance
Phone
(603) 663-4904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

275 Mammoth Rd Ste 1
Pediatric Health Associates
Manchester, NH 03109-4133

Mailing address

275 Mammoth Rd Ste 1
Pediatric Health Associates
Manchester, NH 03109-4133
Phone (603) 663-8350

Other identifiers 2

IdentifierTypeStateIssuer
CG2227OtherNHRR MEDICARE GROUP #
30210585MedicaidNH

Other names 1

  • Pediatric Health Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elliot Physician Network28 organizations share this tax ID, including this one
Part of
Elliot Physician Network

Other organizations with this tax ID 27

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

View all 27

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1861483489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 MAMMOTH RD STE 1",
            "address_2": "PEDIATRIC HEALTH ASSOCIATES",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031094133",
            "telephone_number": "603-663-8350",
            "fax_number": "603-663-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MAMMOTH RD STE 1",
            "address_2": "PEDIATRIC HEALTH ASSOCIATES",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031094133",
            "telephone_number": "603-663-8350",
            "fax_number": "603-663-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOT PHYSICIANS NETWORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLIOT PHYSICIANS NETWORK",
        "enumeration_date": "2005-11-02",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS & FINANCE",
        "authorized_official_telephone_number": "603-663-4904"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP #",
            "identifier": "CG2227",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30210585",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Health Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.