Individual provider Active NPI

Donald Eberly, MD

  • Surgery Physician
  • New London, NH
National Provider Identifier
1922059427
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
6179 Issued in NH
Practice address
273 County Rd
New London, NH 03257-5736
Phone
(603) 526-5544
Fax
(603) 526-5085
NPI assigned
May 12, 2006
Last updated
Mar 16, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 6179 NH Primary

Addresses

Primary practice location

273 County Rd
New London, NH 03257-5736

Mailing address

PO Box 2150
New London, NH 03257-2150
Phone (603) 526-5292

Other identifiers 1

IdentifierTypeStateIssuer
30011520MedicaidNH

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6179NHMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Surgery & Gastroenterology, LLC Surgery Current Accepting new patients
Associates in Surgery and Gastroenterology LLC CurrentSince May 7, 2004 Accepting new patients

Locations

7 Dunning St
Claremont, NH 03743
Phone (603) 542-6700

289 County Rd
Windsor, VT 05089
Phone (802) 674-7220

Organizations & group practices 2

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1922059427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2150",
            "city": "NEW LONDON",
            "state": "NH",
            "postal_code": "032572150",
            "telephone_number": "603-526-5292",
            "fax_number": "603-526-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 COUNTY RD",
            "city": "NEW LONDON",
            "state": "NH",
            "postal_code": "032575736",
            "telephone_number": "603-526-5544",
            "fax_number": "603-526-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLY",
        "first_name": "DONALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NH",
            "license": "6179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30011520",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.