Active NPI
Keith A Waddell, DPT
- Orthopedic Physical Therapist
- Bedford, NH
National Provider Identifier
1952892069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PENDING
- Practice address
- 40 S River Rd Unit 58
Bedford, NH 03110-6751 - Phone
- (603) 626-4205
- NPI assigned
- May 24, 2018
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PENDING | NH | Primary |
Addresses
Primary practice location
40 S River Rd Unit 58
Bedford, NH 03110-6751
Mailing address
40 S River Rd Unit 58
Bedford, NH 03110-6751
Phone (603) 626-4205
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PENDING | NH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527120000000",
"number": "1952892069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 S RIVER RD UNIT 58",
"city": "BEDFORD",
"state": "NH",
"postal_code": "031106751",
"telephone_number": "603-626-4205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 S RIVER RD UNIT 58",
"city": "BEDFORD",
"state": "NH",
"postal_code": "031106751",
"telephone_number": "603-626-4205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADDELL",
"first_name": "KEITH",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-24",
"last_updated": "2018-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NH",
"license": "PENDING",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.