Active NPI
Terri L Lally, M.D.
- Pediatrics Physician
- Dover, NH
National Provider Identifier
1891753968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 8315
- Practice address
- 17 Old Rollinsford Rd
Dover, NH 03820-2827 - Phone
- (603) 742-4048
- Fax
- (603) 743-3345
- NPI assigned
- May 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 8315 | NH | Primary |
Addresses
Primary practice location
17 Old Rollinsford Rd
Dover, NH 03820-2827
Mailing address
99 Goodwin Rd
Kittery Point, ME 03905-5224
Phone (603) 742-4048
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30003620 | Medicaid | NH | |
| NH1044 | Other | NH | HARVARD PILGRAM HEALTH |
| 20067Y | Other | NH | ANTHEM PROVIDER NUMBER |
| 7001338 | Other | NH | AETNA PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8315 | NH | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1891753968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 GOODWIN RD",
"city": "KITTERY POINT",
"state": "ME",
"postal_code": "039055224",
"telephone_number": "603-742-4048",
"fax_number": "603-743-3345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 OLD ROLLINSFORD RD",
"city": "DOVER",
"state": "NH",
"postal_code": "038202827",
"telephone_number": "603-742-4048",
"fax_number": "603-743-3345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LALLY",
"first_name": "TERRI",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NH",
"license": "8315",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30003620",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRAM HEALTH",
"identifier": "NH1044",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "20067Y",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER #",
"identifier": "7001338",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dover, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.