Active NPI
County of Rockingham
Doing business as Rockingham County Nursing Home
- Nursing Facility/Intermediate Care Facility
- Brentwood, NH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- License
- 105
- Legal business name
- COUNTY OF ROCKINGHAM
- Doing business as
- Rockingham County Nursing Home
- Practice address
- 117 North Rd
Brentwood, NH 03833-6624 - Phone
- (603) 679-5335
- NPI assigned
- Mar 22, 2007
- Last updated
- Aug 8, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Charles Nickerson
- Title
- Director of Finance
- Phone
- (603) 679-9341
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | 2202 | NH | |
| Assisted Living Facility | 310400000X | 02934 | NH | |
| Nursing Facility/Intermediate Care Facility | 313M00000X | 105 | NH | Primary |
| Skilled Nursing Facility | 314000000X | 105 | NH | |
| General Practice Physician | 208D00000X | 105 | NH |
Addresses
Primary practice location
117 North Rd
Brentwood, NH 03833-6624
Mailing address
117 North Rd
Brentwood, NH 03833-6624
Phone (603) 679-5335
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30580934 | Medicaid | NH | |
| 30210758 | Medicaid | NH | |
| 3071581 | Medicaid | NH | |
| 3081044 | Medicaid | NH | |
| 3059324 | Medicaid | NH | |
| 3076690 | Medicaid | NH | |
| 30590933 | Medicaid | NH | |
| 49750052 | Medicaid | NH |
Other names 1
- Rockingham County Nursing Home
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
Enrollment records 2
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1972629582. Details of each certification follow.
Skilled nursing facility certification: CCN 305046
- Legal name
- COUNTY OF ROCKINGHAM
- Doing business as
- ROCKINGHAM COUNTY NURSING HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 11, 1995
- Last certification
- Aug 22, 2024
- Beds
- 226
- Ownership / control type
- County
- Organization structure
- Government
- Enrollment address
- 117 North Rd
Rockingham County Nursing Home
Brentwood, NH 03833-6624 - Nursing home name
- ROCKINGHAM COUNTY NURSING HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Rockingham County Nursing Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Government - County
- Certified
- Nov 11, 1995
- Medicare certification status
- Active
- Certified beds
- 226
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 30D0652762 | Rockingham County Rehabilitation & Nursing Center | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 16
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Steven Goddu | Managing Control - Governing Body | Jan 1, 2023 | |
| Adp of the SNF | Jan 1, 2023 | ||
| Kendra a Mayall | Operational/Managerial Control | Jul 27, 2025 | |
| Adp of the SNF | Jul 27, 2025 | ||
| County of Rockingham | 5% Or Greater Direct Ownership Interest | Jan 1, 1970 | 100% |
| Adp of the SNF | Jan 14, 2026 | ||
| Direct Ownership Interest | Jan 1, 1970 | 100% | |
| Siobhan E Farwell | Operational/Managerial Control | Jan 27, 2025 | |
| Adp of the SNF | Jan 27, 2025 | ||
| Jennifer J Prentice | Operational/Managerial Control | Sep 11, 2023 | |
| Adp of the SNF | Sep 11, 2023 | ||
| Tammy Duffy | Corporate Officer | Nov 24, 2021 | |
| Operational/Managerial Control | Jun 26, 2013 | ||
| Adp of the SNF | Jun 23, 2013 | ||
| Thomas N Tombarello | Managing Control - Governing Body | Jan 8, 2025 | |
| Adp of the SNF | Jan 8, 2025 | ||
| Alison J Kivikoski | Operational/Managerial Control | Apr 20, 2015 | |
| Adp of the SNF | Apr 20, 2015 | ||
| Richard T Schimpf | Operational/Managerial Control | Aug 18, 2025 | |
| Adp of the SNF | Aug 18, 2025 | ||
| Judith a Gates | Operational/Managerial Control | Mar 1, 2005 | |
| Adp of the SNF | Mar 1, 2005 | ||
| Bruce O Bourbeau | Operational/Managerial Control | Nov 17, 2025 | |
| Adp of the SNF | Nov 17, 2025 | ||
| Chantal Djakonan | Operational/Managerial Control | Sep 3, 2024 | |
| Adp of the SNF | Sep 3, 2024 | ||
| Charles Nickerson | Corporate Director | Nov 21, 2021 | 100% |
| Operational/Managerial Control | Jan 27, 2009 | ||
| Adp of the SNF | Jan 27, 2009 | ||
| Kathryn Coyle | Managing Control - Governing Body | Jan 1, 2021 | |
| Adp of the SNF | Jan 1, 2021 | ||
| Kristin E Vaughan | Operational/Managerial Control | May 1, 2024 | |
| Adp of the SNF | May 1, 2024 | ||
| Katherine-Ann Masso | Operational/Managerial Control | Dec 19, 2022 | |
| Adp of the SNF | Dec 19, 2022 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Exeter, NH
- NPI 1124097357
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 8
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.
-
- Family Nurse Practitioner
- Nashua, NH
- NPI 1255487195
-
- Family Medicine Physician
- Raymond, NH
- NPI 1508931890
-
- Internal Medicine Physician
- Newmarket, NH
- NPI 1477529824
-
- Family Medicine Physician
- Raymond, NH
- NPI 1881693968
-
- Internal Medicine Physician
- Portsmouth, NH
- NPI 1124640107
-
- Hospice and Palliative Medicine (Family Medicine) Physician
- Exeter, NH
- NPI 1831313923
-
- Internal Medicine Physician
- Exeter, NH
- NPI 1760403968
-
- Family Medicine Physician
- Exeter, NH
- NPI 1124097357
Affiliated clinicians 9
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1723075200000",
"number": "1972629582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 NORTH RD",
"city": "BRENTWOOD",
"state": "NH",
"postal_code": "038336624",
"telephone_number": "603-679-5335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 NORTH RD",
"city": "BRENTWOOD",
"state": "NH",
"postal_code": "038336624",
"telephone_number": "603-679-5335"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF ROCKINGHAM",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-22",
"last_updated": "2024-08-08",
"certification_date": "2024-08-08",
"status": "A",
"authorized_official_last_name": "NICKERSON",
"authorized_official_first_name": "CHARLES",
"authorized_official_title_or_position": "DIRECTOR OF FINANCE",
"authorized_official_telephone_number": "603-679-9341"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": "NH",
"license": "2202",
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "NH",
"license": "02934",
"primary": false
},
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": "NH",
"license": "105",
"primary": true
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NH",
"license": "105",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NH",
"license": "105",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30580934",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30210758",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3071581",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3081044",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3059324",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3076690",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30590933",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "49750052",
"state": "NH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Rockingham County Nursing Home",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Rockingham County Nursing Home",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Brentwood, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.