NPIMap

Organization Active NPI

Merrimack Valley Pet PC

Doing business as New England PET Imaging System

  • Mobile Radiology Clinic/Center
  • Manchester, NH
National Provider Identifier
1922055094
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X
License
446R Issued in NH
Legal business name
MERRIMACK VALLEY PET PC
Doing business as
New England PET Imaging System
Practice address
185 Queen City Ave
Manchester, NH 03101-7121
Phone
(603) 663-2370
Fax
(603) 663-2379
NPI assigned
May 27, 2006
Last updated
Jan 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Mark R Taylor
Title
Ceo
Phone
(978) 933-9311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mobile Radiology Clinic/Center 261QR0208X 446R NH Primary

Addresses

Primary practice location

185 Queen City Ave
Manchester, NH 03101-7121

Mailing address

35 New England Business Center Dr Ste 103
Andover, MA 01810-1080
Phone (978) 933-9311

Other names 1

  • New England PET Imaging System Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050106000149 NH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7810945888 Practice locations: Manchester, NH

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Merrimack Valley Pet PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

354 Merrimack St
Lawrence, MA 01843
Phone (978) 688-3898

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1922055094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 NEW ENGLAND BUSINESS CENTER DR STE 103",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018101080",
            "telephone_number": "978-933-9311",
            "fax_number": "978-933-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 QUEEN CITY AVE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031017121",
            "telephone_number": "603-663-2370",
            "fax_number": "603-663-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERRIMACK VALLEY PET PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "978-933-9311"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NH",
            "license": "446R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New England PET Imaging System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.