Individual provider Active NPI

Thalia Gwynne Stolper

  • Nurse Practitioner
  • Laconia, NH
National Provider Identifier
1912730748
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
069393-23 Issued in NH
Practice address
40 Beacon Street E
Laconia, NH 03246
Phone
(603) 524-1100
NPI assigned
Aug 26, 2024
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 069393-23 NH Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 069393-23 NH

Addresses

Primary practice location

40 Beacon Street E
Laconia, NH 03246

Mailing address

40 Beacon Street E
Laconia, NH 03246
Phone (603) 524-1100

Other names 1

  • Thalia Nietzel Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250217002537 NH Practitioner - Nurse Practitioner 7911427216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Lakes Region Mental Health Center, IncGroup PAC ID 7911957964, 21 clinicians

Practice addresses (Care Compare)

40 Beacon St E
Laconia, NH 03246-3437
Phone (603) 524-1100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
069393-23NHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Lakes Region Mental Health Center, Inc. CurrentSince Dec 16, 2024 Accepting new patients

Locations

40 Beacon St E
Laconia, NH 03246

85 Spring St
Laconia, NH 03246
Phone (603) 524-7402

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1912730748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BEACON STREET E",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "03246",
            "telephone_number": "603-524-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BEACON STREET E",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "03246",
            "telephone_number": "603-524-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLPER",
        "first_name": "THALIA",
        "middle_name": "GWYNNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "069393-23",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "069393-23",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THALIA",
            "last_name": "NIETZEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Laconia, NH

Sources for this page

Verify at the official NPI Registry.