Individual provider Active NPI

Ken Maynard, M.D.

  • Neurological Surgery Physician
  • Portsmouth, NH
National Provider Identifier
1861812372
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
24589 Issued in NH
Practice address
330 Borthwick Ave Ste 300
Portsmouth, NH 03801-7109
Phone
(603) 433-4666
Fax
(603) 433-1338
NPI assigned
Apr 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 24589 NH Primary
Neurological Surgery Physician 207T00000X BP10052651 TX
Neurological Surgery Physician 207T00000X MD18183 RI

Addresses

Primary practice location

330 Borthwick Ave Ste 300
Portsmouth, NH 03801-7109

Mailing address

330 Borthwick Ave Ste 300
Portsmouth, NH 03801-7109
Phone (603) 433-4666

Other practice location 1

593 Eddy Street APC 6
Providence, RI 02903
Phone (401) 793-9166

Other practice location 2

301 University Blvd
Galveston, TX 77555-0517
Phone (409) 772-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230831003128 NH Practitioner - Neurosurgery 0648559815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appledore Medical Group IncGroup PAC ID 5698666154, 197 clinicians

Practice addresses (Care Compare)

11 Whitehall Rd
Rochester, NH 03867-3226
Phone (603) 332-5211

330 Borthwick Ave
Suite 205
Portsmouth, NH 03801-7109
Phone (603) 433-4666

330 Borthwick Ave
Suite 308
Portsmouth, NH 03801-7112
Phone (603) 431-5242

333 Borthwick Ave
Portsmouth, NH 03801-7128

7 Alumni Dr
Exeter, NH 03833-2118
Phone (603) 433-4666

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion84
Laminectomy or laminotomy (partial removal of spine bones)44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24589NHMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Appledore Medical Group Dba Woodbury Family Practice CurrentSince Sep 5, 2023 Accepting new patients
Appledore Medical Group, Inc Neurological Surgery CurrentSince Sep 5, 2023 Accepting new patients

Locations

330 Borthwick Ave
Ste 300
Portsmouth, NH 03801
Phone (603) 433-4666

330 Borthwick Ave
Ste 201
Portsmouth, NH 03801
Phone (603) 431-5242

330 Borthwick Ave
Ste 308
Portsmouth, NH 03801
Phone (603) 431-5242

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: ken.maynard@hca6.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1861812372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BORTHWICK AVE STE 300",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017109",
            "telephone_number": "603-433-4666",
            "fax_number": "603-433-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BORTHWICK AVE STE 300",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017109",
            "telephone_number": "603-433-4666",
            "fax_number": "603-433-1338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy Street APC 6",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "02903",
            "country_code": "US",
            "telephone_number": "401-793-9166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Galveston",
            "state": "TX",
            "postal_code": "775550517",
            "country_code": "US",
            "telephone_number": "409-772-1500",
            "fax_number": "409-772-1742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "KEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NH",
            "license": "24589",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "BP10052651",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "RI",
            "license": "MD18183",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.