| Cranmore Health Partners, Llc | |
|
15 Us Rte 302 Unit 1 Glen NH 03838-6300 | |
| (603) 730-5356 | |
| Not Available |
| Full Name | Cranmore Health Partners, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15 Us Rte 302, Glen, New Hampshire |
| Authorized Official Name and Position | Kelly C Defeo (PARTNER) |
| Authorized Official Contact | 6033874523 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cranmore Health Partners, Llc Po Box 125 Center Conway NH 03813-0125 Ph: (603) 387-4523 | Cranmore Health Partners, Llc 15 Us Rte 302 Unit 1 Glen NH 03838-6300 Ph: (603) 730-5356 |
| NPI Number | 1194364083 |
|---|---|
| Provider Enumeration Date | 12/26/2019 |
| Last Update Date | 04/08/2025 |
| Medicare PECOS PAC ID | 3971933029 |
|---|---|
| Medicare Enrollment ID | O20200414001261 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194364083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Sohaib Siddiqui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073712725 PECOS PAC ID: 2466545603 Enrollment ID: I20070905000225 |
| Provider Name | Kelly C Defeo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699757906 PECOS PAC ID: 4284548439 Enrollment ID: I20140417001454 |
| Provider Name | Todd Hope |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255546941 PECOS PAC ID: 2163551789 Enrollment ID: I20150115001604 |
| Provider Name | Zachary B Chase |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609283118 PECOS PAC ID: 9436378130 Enrollment ID: I20170222000159 |
| Provider Name | Ahmad Rashid |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1124473608 PECOS PAC ID: 8921435074 Enrollment ID: I20200302000567 |
| Provider Name | Kevin J Larochelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902436579 PECOS PAC ID: 4981032422 Enrollment ID: I20200317001414 |
| Provider Name | Shannon L Knecht |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558976381 PECOS PAC ID: 0446664080 Enrollment ID: I20210122001138 |
| Provider Name | Devon Barger |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902855224 PECOS PAC ID: 2365420874 Enrollment ID: I20210205000192 |
| Provider Name | Alicia Mudgett |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1801464342 PECOS PAC ID: 6406259142 Enrollment ID: I20210719003536 |