NPIMap

Organization Active NPI

Derry Medical Center, PA

  • Family Medicine Physician
  • Derry, NH
National Provider Identifier
1922030493
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DERRY MEDICAL CENTER, PA
Practice address
6 Tsienneto Rd
Suite 100
Derry, NH 03038-1584
Phone
(603) 537-1300
Fax
(603) 537-1326
NPI assigned
Jul 7, 2006
Last updated
Apr 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Authorized official

Name
Tonya Lyn Wilson
Title
Billing/Credentialing Manager
Phone
(603) 537-1317

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X
Pain Medicine (Anesthesiology) Physician 207LP2900X
Family Medicine Physician 207Q00000X Primary
Sports Medicine (Family Medicine) Physician 207QS0010X
Nephrology Physician 207RN0300X

Addresses

Primary practice location

6 Tsienneto Rd
Suite 100
Derry, NH 03038-1584

Mailing address

14B Tsienneto Rd
Derry, NH 03038-1560
Phone (603) 537-1300

Other practice location 1

49 Range Rd Ste 104
Windham, NH 03087-2029
Phone (603) 537-1300

Other practice location 2

160 S River Rd
Bedford, NH 03110-6927
Phone (603) 537-1300

Other practice location 3

81 Hall St
Concord, NH 03301-3420
Phone (603) 537-1300

Other practice location 4

89 S Mast St
Goffstown, NH 03045-6102
Phone (603) 537-1300

Other practice location 5

50 Michel's Way
Suite 102
Londonderry, NH 03053
Phone (603) 537-1300

Other practice location 6

15 Tsienneto Rd
Derry, NH 03038-1557
Phone (603) 537-1300

Other practice location 7

6 Old Fremont Rd
Raymond, NH 03077
Phone (603) 537-1300

Other practice location 8

282 Route 101
Units 9&10
Amherst, NH 03031
Phone (603) 249-8883

Other practice location 9

14A Tsienneto Rd
Derry, NH 03038-1505
Phone (603) 537-1300

Other identifiers 2

IdentifierTypeStateIssuer
709488OtherNHTUFTS
83019373MedicaidNH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625000380 NH Part B Supplier - Clinic/Group Practice 5294711768 Receives reassigned benefits from 115 practitioners
Practice locations: Windham, NH; Raymond, NH; Londonderry, NH; Goffstown, NH; Derry, NH; Concord, NH; Bedford, NH; Amherst, NH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
30D1062905Derry Medical Center282 Route 101 Unit 9&10, Amherst, NH 03031Provider-performed microscopyDec 28, 2026
30D2047781Derry Medical Center49 Range Rd, Windham, NH 03087Provider-performed microscopyOct 2, 2026
30D2125020Derry Medical Center160 South River Rd, Bedford, NH 03110Certificate of waiverJan 30, 2027
30D2190499Derry Medical Center, PA15 Tsienneto Rd, Derry, NH 03038Certificate of waiverAug 13, 2026
30D2190750Derry Medical Center14 Tsienneto Rd, Ste 300, Derry, NH 03038Provider-performed microscopyAug 18, 2026

National Provider Directory

National Provider Directory

Locations

14 Tsienneto Rd
#B
Derry, NH 03038

14 Tsienneto Rd
Bldg B
Derry, NH 03038

14B Tsienneto Rd
Derry, NH 03038
Phone (603) 537-1317

15 Tsienneto Rd
Derry, NH 03038
Phone (603) 399-6998

15 Durham Rd
Ste 105
Dover, NH 03820

50 Michels Way
Unit 102
Londonderry, NH 03053

6 Buttrick Rd
Ste 102
Londonderry, NH 03053
Phone (603) 537-1308

49 Range Rd
Ste 104
Windham, NH 03087

Practitioners & affiliated clinicians

Practitioners 142

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 142

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1922030493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14B TSIENNETO RD",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381560",
            "telephone_number": "603-537-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO RD",
            "address_2": "SUITE 100",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381584",
            "telephone_number": "603-537-1300",
            "fax_number": "603-537-1326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "49 Range Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Windham",
            "state": "NH",
            "postal_code": "030872029",
            "country_code": "US",
            "telephone_number": "603-537-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 S River Rd",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "NH",
            "postal_code": "031106927",
            "country_code": "US",
            "telephone_number": "603-537-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "81 Hall St",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NH",
            "postal_code": "033013420",
            "country_code": "US",
            "telephone_number": "603-537-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "89 S Mast St",
            "address_purpose": "LOCATION",
            "city": "Goffstown",
            "state": "NH",
            "postal_code": "030456102",
            "country_code": "US",
            "telephone_number": "603-537-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Michel's Way",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Londonderry",
            "state": "NH",
            "postal_code": "03053",
            "country_code": "US",
            "telephone_number": "603-537-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Tsienneto Rd",
            "address_purpose": "LOCATION",
            "city": "Derry",
            "state": "NH",
            "postal_code": "030381557",
            "country_code": "US",
            "telephone_number": "603-537-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Old Fremont Rd",
            "address_purpose": "LOCATION",
            "city": "Raymond",
            "state": "NH",
            "postal_code": "03077",
            "country_code": "US",
            "telephone_number": "603-537-1300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "282 Route 101",
            "address_2": "Units 9&10",
            "address_purpose": "LOCATION",
            "city": "Amherst",
            "state": "NH",
            "postal_code": "03031",
            "country_code": "US",
            "telephone_number": "603-249-8883",
            "fax_number": "603-249-1107",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14A Tsienneto Rd",
            "address_purpose": "LOCATION",
            "city": "Derry",
            "state": "NH",
            "postal_code": "030381505",
            "country_code": "US",
            "telephone_number": "603-537-1300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DERRY MEDICAL CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "603-537-1317"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "709488",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "83019373",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.