Individual provider Active NPI

Jeffrey Charles Fetter, MD

  • Psychiatry Physician
  • Concord, NH
National Provider Identifier
1902855695
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
13042 Issued in NH
Practice address
10 West St
Concord, NH 03301-3548
Phone
(603) 225-0123
NPI assigned
May 9, 2006
Last updated
Nov 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 13042 NH
Psychiatry Physician 2084P0800X 13042 NH Primary

Addresses

Primary practice location

10 West St
Concord, NH 03301-3548

Mailing address

PO Box 2032
Concord, NH 03302-2032

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
I20070216000497 NH Practitioner - PsychiatryPractitioner - Internal Medicine 1557463890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Internal Medicine
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of New HampshireGroup PAC ID 3870530579, 77 clinicians

Practice addresses (Care Compare)

36 Clinton St
Concord, NH 03301-2359
Phone (603) 271-5300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of New Hampshire CurrentSince Jul 31, 2020 Accepting new patients
State of New Hampshire CurrentSince Jul 31, 2020 Accepting new patients
Concord Hospital, Inc. Past Accepting new patients

Locations

36 Clinton St
Concord, NH 03301
Phone (603) 271-5075

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1902855695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2032",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033022032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WEST ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033013548",
            "telephone_number": "603-225-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTER",
        "first_name": "JEFFREY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "13042",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "13042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.