NPIMap

Organization Active NPI

Ibis Health Services-New Hampshire PLLC

  • Family Medicine Physician
  • Nashua, NH
National Provider Identifier
1871087619
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
IBIS HEALTH SERVICES-NEW HAMPSHIRE PLLC
Practice address
24 Heathrow CT
Nashua, NH 03063-1524
Phone
(603) 664-4800
Fax
(207) 401-2727
NPI assigned
Jun 15, 2018
Last updated
Aug 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Authorized official

Name
Mr. Gary M Janko
Title
Administrator
Phone
(603) 921-4947

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

24 Heathrow CT
Nashua, NH 03063-1524

Mailing address

215 Ayer Rd Unit 797
Harvard, MA 01451-5033
Phone (603) 664-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180912001872 NH Part B Supplier - Clinic/Group Practice 4486904422 Receives reassigned benefits from 12 practitioners
Practice locations: Nashua, NH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1871087619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 AYER RD UNIT 797",
            "city": "HARVARD",
            "state": "MA",
            "postal_code": "014515033",
            "telephone_number": "603-664-4800",
            "fax_number": "207-401-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HEATHROW CT",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030631524",
            "telephone_number": "603-664-4800",
            "fax_number": "207-401-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBIS HEALTH SERVICES-NEW HAMPSHIRE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-15",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "JANKO",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "603-921-4947",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.