NPIMap

Organization Active NPI

Catholic Medical Center

  • Family Medicine Physician
  • Bedford, NH
National Provider Identifier
1972559904
Registry record updated Jun 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 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
Last updated
Jun 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2009

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

20 Washington PL
Bedford, NH 03110-6706

Mailing address

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

Medicare participation

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

Enrollment records 1

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

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

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

Ownership & related parties

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 CenterManchester, NH, CCN 301823 Federally qualified health center Operational/Managerial Control Jun 16, 2010

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 101

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.

View all 101

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244160000000",
    "number": "1972559904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WASHINGTON PLACE",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "03110",
            "telephone_number": "603-663-7852",
            "fax_number": "603-663-7895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WASHINGTON PL",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106706",
            "telephone_number": "603-663-8060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2009-06-05",
        "status": "A",
        "authorized_official_last_name": "MCKELLAR",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "603-663-5248"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, NH

Sources for this page

Verify at the official NPI Registry.