NPIMap

Organization Active NPI

Saco River Medical Group, PC

  • Family Medicine Physician
  • Conway, NH
National Provider Identifier
1861587453
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SACO RIVER MEDICAL GROUP, PC
Practice address
7 Greenwood Ave
Conway, NH 03818-6130
Phone
(603) 447-3500
Fax
(603) 447-5568
NPI assigned
Oct 3, 2006
Last updated
May 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Authorized official

Name
Ross Emery, MDNPI 1477647915
Title
President
Phone
(603) 447-3500

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X N/A NH
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X NA NH
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X N/A NH
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X NA NH
Rural Health Clinic/Center 261QR1300X
Urgent Care Clinic/Center 261QU0200X N/A NH

Addresses

Primary practice location

7 Greenwood Ave
Conway, NH 03818-6130

Mailing address

7 Greenwood Ave
Conway, NH 03818-6130
Phone (603) 447-3500

Other identifiers 1

IdentifierTypeStateIssuer
40303814MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030530000071 NH Part A Provider - Rural Health Clinic 7911817291 Practice locations: Conway, NH
O20040623000272 NH Part B Supplier - Clinic/Group Practice 7911817291 Receives reassigned benefits from 18 practitioners
Practice locations: Conway, NH

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1861587453. Details of each certification follow.

Rural health clinic certification: CCN 303814A

Legal name
SACO RIVER MEDICAL GROUP, PC
Organization structure
CorporationProprietary
Incorporated
Apr 9, 1996
Enrollment address
7 Greenwood Ave
Conway, NH 03818-6130

Rural health clinic certification: CCN 303814

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SACO RIVER MEDICAL GROUP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 12, 1994
Last certification
Oct 20, 2021
Ownership / control type
1B
Facility address
7 Greenwood Avenue
Conway, NH 03818

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
30D0920300Saco River Medical Group PC7 Greenwood Ave, Conway, NH 03818ComplianceJan 12, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20740/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Franklin R Hubbell Individual 5% Or Greater Direct Ownership Interest Sep 28, 2021 20%
Ross Freixas Emery Individual 5% Or Greater Direct Ownership Interest Sep 28, 2021 20%
Corporate OfficerPresident/Administrator Jan 1, 2014
Judith Brewster Individual 5% Or Greater Direct Ownership Interest Sep 28, 2021 20%
Richard Laracy Individual 5% Or Greater Direct Ownership InterestVice President Sep 28, 2021 20%
Rebecca Pelchat Individual W-2 Managing EmployeeAccount Manager Jan 1, 2025
Emily E Beaulieu Individual 5% Or Greater Direct Ownership Interest Sep 28, 2021 20%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746489600000",
    "number": "1861587453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 GREENWOOD AVE",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038186130",
            "telephone_number": "603-447-3500",
            "fax_number": "603-447-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 GREENWOOD AVE",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038186130",
            "telephone_number": "603-447-3500",
            "fax_number": "603-447-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACO RIVER MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A",
        "authorized_official_last_name": "EMERY",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-447-3500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "N/A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NH",
            "license": "NA",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NH",
            "license": "N/A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "NA",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NH",
            "license": "N/A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40303814",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, NH

Sources for this page

Verify at the official NPI Registry.