Active NPI
Robert Clyde Vidaver, M.D.
- Psychiatry Physician
- Concord, NH
National Provider Identifier
1932253358
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective May 19, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- RT 1643
- Practice address
- 36 Clinton St
New Hampshire Hospital
Concord, NH 03301-2359 - Phone
- (603) 271-5485
- NPI assigned
- Jan 23, 2007
- Last updated
- Jun 1, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | RT 1643 | NH | Primary |
Addresses
Primary practice location
36 Clinton St
New Hampshire Hospital
Concord, NH 03301-2359
Mailing address
36 Clinton St
New Hampshire Hospital
Concord, NH 03301-2359
Phone (603) 271-5485
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT 1643 | NH | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306886400000",
"number": "1932253358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 CLINTON ST",
"address_2": "NEW HAMPSHIRE HOSPITAL",
"city": "CONCORD",
"state": "NH",
"postal_code": "033012359",
"telephone_number": "603-271-5485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 CLINTON ST",
"address_2": "NEW HAMPSHIRE HOSPITAL",
"city": "CONCORD",
"state": "NH",
"postal_code": "033012359",
"telephone_number": "603-271-5485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDAVER",
"first_name": "ROBERT",
"middle_name": "CLYDE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2011-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NH",
"license": "RT 1643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.