BEDFORD PEDIATRICS, P.A. (NPI# 1528184439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528184439 |
| Entity Type | Organization |
| Organization Name | BEDFORD PEDIATRICS, P.A. |
| Practice Address |
360 Route 101 Unit 7b Bedford NH 03110-5030 |
| Practice Telephone | 6034710831 |
| Practice Fax Number | 6034710890 |
| Mailing Telephone | 6034710831 |
| Mailing Fax Number | 6034710890 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KERMIT BRUNELLE (PRESIDENT) |
| Authorized Official Telephone | 6034710831 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | 30210849 | 05 |
| Street Address |
360 ROUTE 101 UNIT 7B |
| City | BEDFORD |
| State | NH |
| Zip Code | 03110-5030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407859697 | Kathleen M Corkery | Social Worker | 360 Route 101, Ste 10, Bedford, NH 03110-5031 | 2005-05-23 |
| 1568909414 | Elizabeth Rourke | Counselor | 360 Route 101, Unit 10, Bedford, NH 03110-5030 | 2017-01-30 |
| 1609228188 | Shs Nh, LLC | Home Health | 360 Route 101, Suite 3b, Bedford, NH 03110-5030 | 2016-07-07 |
| 1386098168 | Courtney Elizabeth Jameson | Behavioral Analyst | 360 Route 101, Suite 11, Bedford, NH 03110-5030 | 2016-04-19 |
| 1104270982 | Samantha Lynn Wolf | Behavioral Analyst | 360 Route 101, Suite 11, Bedford, NH 03110-5030 | 2016-04-19 |
| 1881082931 | Desired Care Chiropractic, Pllc | Chiropractor | 360 Route 101, Unit 13 B, Bedford, NH 03110-5030 | 2014-12-23 |
| 1275931057 | Desiree Shelby Frasier | Chiropractor | 360 Route 101, Unit 13b, Bedford, NH 03110-5030 | 2014-12-10 |
| 1205231321 | Melanie Theresa Deflumeri | Behavioral Analyst | 360 Route 101, Suite 11, Bedford, NH 03110 | 2014-10-31 |
| 1679911630 | Kerri Elizabeth Mcgilvreay | Behavioral Analyst | 360 Route 101, Suite 11, Bedford, NH 03110-5030 | 2013-06-11 |
| 1467716852 | Rachael Erin Alling | Behavioral Analyst | 360 Route 101, Suite 11, Bedford, NH 03110-5030 | 2012-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114587300 | Jillian Lee Grosse | Dietitian, Registered | 80 Palomino Lane Nutrition In Motion, LLC, Suite 101, Bedford, NH 03110 | 2019-06-19 |
| 1154892909 | Artemis Clinic | Acupuncturist | 288 South River Road, Bldg A, Unit 1, Bedford, NH 03110 | 2018-12-05 |
| 1942790217 | Wendy Arleen Williams | Acupuncturist | 360 Route 101 Bldg. 1, Suite E, Bedford, NH 03110 | 2018-05-13 |
| 1336638352 | Elliot Hospital of The City of Manchester | Pharmacy | 25 Leavy Dr, Bedford, NH 03110 | 2018-05-04 |
| 1588182034 | Camille Redmond | Nutritionist | 360 Route 101 Suite 3 A, Bedford, NH 03110 | 2017-09-05 |
| 1750837092 | Katya Kudryavtseva | Acupuncturist | 288 South River Rd, Bldg A, Unit 1, Bedford, NH 03110 | 2016-08-28 |
| 1003268004 | Bethany Heidemann | Occupational Therapist | 66 Hawthorne Dr S, Bedford, NH 03110 | 2016-07-01 |
| 1477913044 | Ultraflex Systems Inc. | Durable Medical Equipment & Medical Supplies | 150 Constitution Drive, 1st Floor, Bedford, NH 03110 | 2016-02-25 |
| 1508243676 | Lydia Ann Nickerson | Dental Hygienist | 4 Bell Hill Rd., Bedford, NH 03110 | 2015-04-28 |
| 1629477021 | Convenientmd LLC | Clinic/Center | 3 Nashua Rd, Bedford, NH 03110 | 2014-08-21 |
| Find all providers in zip 03110 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487616116 | Toby Nathan | Pediatrics | 41 North Rd, Suite 202, Bedford, MA 01730-1037 | 2006-04-06 |
| 1710194410 | Patriot Pediatrics | Pediatrics | 74 Loomis St, Bedford, MA 01730-2248 | 2007-05-16 |
| 1952432387 | Toby Nathan, M.d., PC | Pediatrics | 41 North Rd, Suite 202, Bedford, MA 01730-1037 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821135534 | Anna Maria Konopka | Pediatrics | 92 Bunker Rd, New London, NH 03257 | 2007-01-31 |
| 1447235270 | Bridget L Olsen | Pediatrics | 116 Spit Brook Rd, Nashua, NH 03062-4216 | 2005-12-14 |
| 1104085638 | Pediatric Associates of Hampton & Portsmouth PC | Pediatrics | 330 Borthwick Ave, Suite 202, Portsmouth, NH 03801-4174 | 2008-06-09 |
| 1851413181 | Joann Lopez-valles | Pediatrics | 125 S Main St, Franklin, NH 03235-1508 | 2007-04-06 |
| 1962521278 | Myra Citrin | Pediatrics | 20 Main St, Exeter, NH 03833-2438 | 2007-03-28 |
| 1700959897 | Rochester Pediatrics | Pediatrics | 163 Rochester Hill Rd, Rochester, NH 03867-1728 | 2006-11-16 |
| 1417027509 | Ana Maria Ferrer | Pediatrics | 100 Hitchcock Way, Manchester, NH 03104-4125 | 2006-11-08 |
| 1780772160 | Clare Nichols Drebitko | Pediatrics | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-10-10 |
| 1871605022 | Marjan Makatam-abrams | Pediatrics | One Elliot Way, Elliot Hospital Hospitalist Program, Manchester, NH 03103 | 2006-08-31 |
| 1649383548 | Ardis Lee Olson | Pediatrics | 1 Medical Center Dr, Lebanon, NH 03756-1000 | 2006-08-16 |
| Find all providers with the same taxonomy | ||||
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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.