Manchester Community Health Center

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

MANCHESTER COMMUNITY HEALTH CENTER

Practice address

145 Hollis St
Manchester, NH 03101-1235

Phone

(603) 668-6629

Fax

(603) 622-7680

NPI assigned

Jun 8, 2007

Organization subpart

Yes

Parent organization

MANCHESTER COMMUNITY HEALTH CENTERAs reported in NPPES

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

Authorized official

Name

Lisa A. Dibrigida, MD, MD

Title

Medical Director

Phone

(603) 668-6629

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Child Health Services Doing business as

Medicare fee-for-service enrollment

Enrolled in NH

Enrollment records 1

Federally qualified health center certification: CCN 301829

Legal name

AMOSKEAG HEALTH

Doing business as

CHILD HEALTH SERVICE

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jan 26, 2015

Last certification

Jan 26, 2015

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

May 1, 1992 in NH

Enrollment address

1245 Elm St
Manchester, NH 31011308

Other NPIs on the same Medicare enrollment 1

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

• Amoskeag Health

  • Federally Qualified Health Center (FQHC)
  • Manchester, NH
  • NPI 1295112530

  O20150123000052

  Same enrollment

Part of

Amoskeag Health

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.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Steven Andrew Paris, MD

  • Pediatrics Physician
  • Manchester, NH
  • NPI 1396784468

  Corporate Director

  CMS ownership

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1992908644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 ELM STREET,",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "03101",
            "telephone_number": "602-668-6629",
            "fax_number": "603-622-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HOLLIS ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031011235",
            "telephone_number": "603-668-6629",
            "fax_number": "603-622-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANCHESTER COMMUNITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MANCHESTER COMMUNITY HEALTH CENTER",
        "enumeration_date": "2007-06-08",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "DIBRIGIDA, MD",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "603-668-6629",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82370079",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Child Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zacharia Deng Makuach Mamur
• Manchester Alcoholism Rehabilitation Center
• Manchester Allergy, Inc.
• Manchester Cboc
• Manchester Chiropractic & Sports Injuries, PLLC
• Manchester Community Music School
• Manchester Dental PLLC
• Manchester Dental Surgery and Implant Center
• Manchester Dentistry & Implants PLLC
• Manchester Dentistry and Braces Inc

• Pediatrics Physician in Manchester, NH
• Providers in Manchester, NH by specialty
• Pediatrics Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.