DR. JAN MCGONAGLE (NPI# 1265450936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265450936 |
| Entity Type | Individual |
| Full Name | DR. JAN MCGONAGLE |
| Credential | M.D. |
| Practice Address |
One Verney Drive Cmrc Greenfield NH 03431-1719 |
| Mailing Address |
99 Terrace St Keene NH 03431-3210 |
| Practice Telephone | 6035473311 |
| Practice Fax Number | 6035473232 |
| Mailing Telephone | 6033583927 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2013-08-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 0420010669 | VT | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 9425 | NH | Allopathic & Osteopathic Physicians |
| Y | 2080P0008X |
Pediatrics Specialization: Neurodevelopmental Disabilities |
9425 | NH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | 30008409 | 05 | |
| VT | ORE3780 | 05 |
| Street Address |
ONE VERNEY DRIVE CMRC |
| City | GREENFIELD |
| State | NH |
| Zip Code | 03431-1719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153443 | County of Cheshire | Case Manager/Care Coordinator | 12 Court Street, Finance Department, Keene, NH 03431 | 2020-10-29 |
| 1316506686 | Lynn Marie Noonan | Dental Hygienist | 69v Island Street, Keene, NH 03431 | 2019-06-11 |
| 1467925164 | Barbara B. Dematteo, Pt | Physical Therapist | 70 Island Street, Keene, NH 03431 | 2019-01-04 |
| 1275065591 | Kyle Harriman James | Emergency Medicine | 590 Court St., Keene, NH 03431 | 2017-03-28 |
| 1932584372 | Sarah Gornall | Occupational Therapist | 298 Main St., Keene, NH 03431 | 2015-07-28 |
| 1457748618 | Cassandra Curtis | Massage Therapist | 103 Roxbury Street, Suite # 200d, Keene, NH 03431 | 2015-04-24 |
| 1518354455 | Allen Penrod | Counselor | 170 Emerald Street, Suite 203, Keene, NH 03431 | 2015-04-17 |
| 1447652615 | Cheshire Health Services Inc | Clinic/Center | 149 Emerald St Ste L, Keene, NH 03431 | 2014-09-19 |
| 1053710541 | Louise Howlett | Marriage & Family Therapist | 19 Federal St., Keene, NH 03431 | 2014-08-20 |
| 1861816076 | Christine Fleming | Physical Therapy Assistant | 197 Water Street, Keene, NH 03431 | 2014-02-07 |
| Find all providers in zip 03431 | ||||
| Taxonomy Code | 2080P0008X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neurodevelopmental Disabilities |
| A pediatrician who treats children having developmental delays or learning disorders including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669573481 | Claudia Cavagnaro Gibson | Pediatrics | 33 E Wilder Rd, West Lebanon, NH 03784-3106 | 2006-09-26 |
| 1740282375 | Jeffrey D Rind | Pediatrics | 6 Tsienneto Rd, Suite 302, Derry, NH 03038-1584 | 2005-08-12 |
| 1457757254 | Maritza Feliz Cepin | Pediatrics | One Medical Center Drive, Lebanon, NH 03756-0001 | 2014-11-06 |
| 1376805317 | David Vargas Lowy | Pediatrics | 100 Mcgregor St, Manchester, NH 03102-3730 | 2012-06-14 |
| 1588822787 | Anna Lecticia Ribeiro Pinto | Pediatrics | 87 Mcgregor St, Suite 1300, Manchester, NH 03102-3765 | 2008-05-26 |
| 1780765032 | Raymond T Ferri | Pediatrics | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-10-17 |
| 1477565018 | Richard P Morse | Pediatrics | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-08-12 |
| 1164459368 | Brian David Kossak | Pediatrics | 87 Mcgregor St, Dartmouth Hitchcock - Child Neurology, Manchester, NH 03102-3765 | 2006-06-26 |
| City | GREENFIELD |
| Zip Code | 03431 |
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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.