DR. HEATHER ANN WISHART (NPI# 1104994680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104994680 |
| Entity Type | Individual |
| Full Name | DR. HEATHER ANN WISHART |
| Credential | PHD |
| Practice Address |
1 Medical Center Drive Lebanon NH 03756-0001 |
| Practice Telephone | 6036507232 |
| Practice Fax Number | 6036509478 |
| Mailing Telephone | 6036507232 |
| Mailing Fax Number | 6036509478 |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 843 | NH | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | MEDICAID | 1006342 | 01 |
| NH | 30011685 | 05 |
| Street Address |
1 MEDICAL CENTER DRIVE |
| City | LEBANON |
| State | NH |
| Zip Code | 03756-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558987560 | Kimberly Ruth Haller | Nurse Practitioner | 1 Medical Center Drive, Lebanon, NH 03756 | 2020-06-25 |
| 1306409818 | Kyle Lance Holsted | Physician Assistant | 1 Medical Center Drive, Department of Surgery, Lebanon, NH 03756-0001 | 2019-04-19 |
| 1639643919 | Michael Patrick Gaffney | Physician Assistant | 1 Medical Center Drive, Dartmouth Hitchcock - Otolaryngology, Lebanon, NH 03756 | 2019-01-19 |
| 1780189134 | Hannah Louise Duane | Student in an Organized Health Care Education/Training Program | 1 Medical Center Drive, Dhmc-dept of Internal Medicine, Lebanon, NH 03756-1000 | 2018-03-28 |
| 1295239135 | Erica Katherine Gotow | Student in an Organized Health Care Education/Training Program | 1 Medical Center Drive, Dhmc Department of Psychiatry, Lebanon, NH 03756-0001 | 2018-03-23 |
| 1427597012 | Evan C Bick | Psychologist | 1 Medical Center Drive, 5d-psychiatry, Lebanon, NH 03756 | 2017-02-16 |
| 1447614391 | James Harvey Elder Iv | Student in an Organized Health Care Education/Training Program | 1 Medical Center Drive, Emergency Medicine Residency Office, Lebanon, NH 03766 | 2016-04-07 |
| 1669866596 | Elizabeth Schwartz | Psychiatry & Neurology | 1 Medical Center Drive, Psychiatry Department, Lebanon, NH 03756-1000 | 2015-03-28 |
| 1841618899 | Minda A Gowarty | Internal Medicine | 1 Medical Center Drive, Dartmouth Hitchcock - Internal Medicine, Lebanon, NH 03756 | 2014-04-06 |
| 1952747446 | Kerrilynn Carney Hennessey | Internal Medicine | 1 Medical Center Drive, Department of Cardiology, Lebanon, NH 03756 | 2013-05-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790277796 | Sindri Aron Viktorsson | Student in an Organized Health Care Education/Training Program | Dartmouth- Hitchcock Medical Center, One Medical Center Dr, Lebanon, NH 03756 | 2018-06-05 |
| 1376078501 | Robert G.p. Murray | Student in an Organized Health Care Education/Training Program | One Medical Center Drive, Pediatric Residency Program, Children's Hospital At Dartmouth-hitchcock, Dartmouth H, Lebanon, NH 03756 | 2017-04-25 |
| 1063946242 | Keira Kilmartin | Student in an Organized Health Care Education/Training Program | One Medical Centre Drive, Pediatric Residency Program, Lebanon, NH 03756 | 2017-04-14 |
| 1194120691 | Clearchoicemd | Clinic/Center | 422 Miracle Mile Rd, Lebanon, NH 03756 | 2014-10-27 |
| 1629380159 | Rattanaporn Mahatanan | Internal Medicine | One Meical Center Drive, Dhmc Infectious Disease Department, Lebanon, NH 03756 | 2010-07-13 |
| 1780803833 | Kenneth W Travis | Anesthesiology | Darmouth Hitchock Med Ct, One Medical Ctre Drive, Lebanon, NH 03756 | 2007-04-25 |
| 1295950657 | Jillian R Ozmore | Genetic Counselor, MS | Dartmouth Hitchcock, One Medical Center Drive, Lebanon, NH 03756 | 2007-04-13 |
| 1609961119 | Athos John Rassias | Anesthesiology | Critical Care Medicine 1 Medical Center Drive, Dhmc, Lebanon, NH 03756 | 2006-10-03 |
| 1679592067 | Martha J Allen | Physician Assistant | Dartmouth Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH 03756 | 2006-07-18 |
| 1194765768 | Joseph Livin Perras II | Internal Medicine | Dartmouth-hitchcock Clinic, 1 Medical Center Dr, Lebanon, NH 03756 | 2006-06-08 |
| Find all providers in zip 03756 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568613073 | Peter Keith Isquith | Clinical Neuropsychologist | 367 Route 120 Unit B1, Hanover Road Professional Center, Lebanon, NH 03766 | 2008-10-02 |
| 1700881463 | John James Randolph | Clinical Neuropsychologist | 20 W Park St, Ste 215, Lebanon, NH 03766-1378 | 2005-06-17 |
| 1821611401 | Cierra Keith | Clinical Neuropsychologist | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2020-05-18 |
| 1699142794 | Catherine Lorraine Williams | Clinical Neuropsychologist | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2015-08-25 |
| 1891863106 | Robert Mark Roth | Clinical Neuropsychologist | 1 Medical Center Drive, Lebanon, NH 03756-0001 | 2006-12-04 |
| 1407924723 | Andrew J Saykin | Clinical Neuropsychologist | 1 Medical Center Drive, Lebanon, NH 03756-0001 | 2006-12-04 |
| 1730131707 | Laura A Flashman | Clinical Neuropsychologist | 1 Medical Center Dr, Dept of Psychiatry Hb7750, Lebanon, NH 03756-1000 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831500511 | Matthew Holcomb | Clinical Neuropsychologist | 335 Bog Rd, Enfield, NH 03748-4103 | 2014-05-15 |
| 1407133226 | Ekaterina Tolstikova | Clinical Neuropsychologist | 150 Myrtle Street, Manchester, NH 03104-6025 | 2011-11-08 |
| 1841244522 | William Thomas Mautz | Clinical Neuropsychologist | 20 Ladd St, 4th Floor, Portsmouth, NH 03801-4089 | 2006-05-19 |
| 1730162843 | William J. Jamieson | Clinical Neuropsychologist | 61 North St, Manchester, NH 03104-3029 | 2005-11-22 |
| 1326035734 | James Beauregard | Clinical Neuropsychologist | 138 Webster St, Manchester, NH 03104-2512 | 2005-09-30 |
| 1003816992 | Douglas F. Watt | Clinical Neuropsychologist | 24 Charlotte Ave, Nashua, NH 03064-1551 | 2005-07-21 |
| 1467801811 | Jessica Y. Rhee | Clinical Neuropsychologist | 40 Buttrick Rd, Londonderry, NH 03053 | 2016-06-07 |
| 1164730420 | Susan R Mcgurk | Clinical Neuropsychologist | 105 Pleasant St, Dartmouth Psychiatric Research Center, Main Building, Concord, NH 03301-3852 | 2010-09-21 |
| 1104059237 | Orion Diagnostics Incorporated | Clinical Neuropsychologist | 138 Elm Street, Newport, NH 03773-0025 | 2009-08-24 |
| 1073745899 | Meagan Etchells Lentz | Clinical Neuropsychologist | 138 Webster St, Manchester, NH 03104-2512 | 2009-08-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.