1912080342 NPI number — DR. THOMAS SHELDON M.D.

Table of content: DR. THOMAS SHELDON M.D. (NPI 1912080342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912080342 NPI number — DR. THOMAS SHELDON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHELDON
Provider First Name:
THOMAS
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912080342
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
291 MOODY ST
Provider Second Line Business Mailing Address:
PER SE
Provider Business Mailing Address City Name:
LUDLOW
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01056-1246
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 PLEASANT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONCORD
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03301-7539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-230-6100
Provider Business Practice Location Address Fax Number:
603-230-6105
Provider Enumeration Date:
10/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0203X , with the licence number:  7290 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0001X , with the licence number: 7290 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02-0449797 . This is a "PHCS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000007153 . This is a "MATTHEW THORNTON" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 02-0449797 . This is a "TRICARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 02-0449797 . This is a "HEALTHCARE VALUE MANAGEME" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 2400069 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30001695 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3025100 . This is a "HMO BLUE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 360002463 . This is a "RR MEDICARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 5941162 . This is a "AETNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30251000 . This is a "BLUE CHOICE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 3041310 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 77843 . This is a "HEALTHY START" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 02-0449797 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4371 . This is a "CIGNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 795767 . This is a "TUFTS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 0102510YONH02 . This is a "ANTHEM BCBS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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