| New Creation Healing Center, Inc | |
|
80 Route 125 Kingston NH 03848-3535 | |
| (603) 642-6700 | |
| (603) 642-6701 |
| Full Name | New Creation Healing Center, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 80 Route 125, Kingston, New Hampshire |
| Authorized Official Name and Position | Mary G Pearson (COO/PHYSICIAN) |
| Authorized Official Contact | 6036426700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Creation Healing Center, Inc 80 Route 125 Kingston NH 03848-3535 Ph: (603) 642-6700 | New Creation Healing Center, Inc 80 Route 125 Kingston NH 03848-3535 Ph: (603) 642-6700 |
| NPI Number | 1477569234 |
|---|---|
| Provider Enumeration Date | 08/01/2006 |
| Last Update Date | 03/05/2009 |
| Medicare PECOS PAC ID | 7911916663 |
|---|---|
| Medicare Enrollment ID | O20060407000564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477569234 | NPI | - | NPPES |
| 30900090 | Medicaid | NH | |
| 9785515 | Medicaid | MA | |
| BCBS | Other | MA | M17086 |
| TUFTS | Other | MA | 681554 |
| HEALTHSOURCE | Other | NH | 15221 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Shawn I Sutton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699712711 PECOS PAC ID: 7416913868 Enrollment ID: I20041207000817 |
| Provider Name | Judy A Misiaszek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568421006 PECOS PAC ID: 9931114485 Enrollment ID: I20060220000564 |
| Provider Name | Mary G Pearson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881654135 PECOS PAC ID: 1557309382 Enrollment ID: I20060323000261 |