Catholic Medical Center

Organization Active NPI Family Medicine Physician · Bedford, NH

NPI 1972559904 · NPPES record last updated Jun 5, 2009

Key facts

NPI
1972559904
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
CATHOLIC MEDICAL CENTER
Practice address
20 Washington PL
Bedford, NH 03110-6706
Phone
(603) 663-8060
NPI assigned
May 25, 2006
Organization subpart
No

Authorized official

Name
Bonnie McKellar
Title
Administrator
Phone
(603) 663-5248

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 9

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

Practitioners 102

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 102

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NH

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Catholic Medical Center
Manchester, NH · CCN 301823
Federally qualified health center Operational/Managerial Control Jun 16, 2010

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20060801000346 NH Part B Supplier - Clinic/Group Practice 6103897129 Receives reassigned benefits from 101 practitioners
1 other NPI on this enrollment
Practice locations: Bedford, NH; Wolfeboro, NH; Peterborough, NH; Manchester, NH

National Provider Directory

Locations

188 State Route 101
Bedford, NH 03110
Phone (603) 314-4700

769 S Main St
Fl 3
Manchester, NH 03102
Phone (603) 625-6198

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X

Addresses

Primary practice location

20 Washington PL
Bedford, NH 03110-6706

Mailing address

20 Washington Place
Bedford, NH 03110
Phone (603) 663-7852

Other providers in Bedford, NH

All providers in Bedford, NH · Family Medicine Physician in New Hampshire

Sources for this page

Verify at the official NPI Registry.