DR. JONATHAN EBERHARD MACK


Address: 185 Queen City Ave, Elliot Orthopaedic Surgery Specialists, Manchester, NH 03101-7100
Phone: 6036251655

DR. JONATHAN EBERHARD MACK (NPI# 1275522625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1275522625
Entity Type Individual
Full Name DR. JONATHAN EBERHARD MACK
Credential M.D.
Practice Address 185 Queen City Ave
Elliot Orthopaedic Surgery Specialists
Manchester
NH 03101-7100
Practice Telephone 6036251655
Practice Fax Number 6036264686
Mailing Telephone 6036251655
Mailing Fax Number 6036264686
Enumeration Date 2005-10-18
Last Update Date 2011-04-13
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207XX0005X Orthopaedic Surgery
Specialization: Sports Medicine
50942 WI Allopathic & Osteopathic Physicians
N 207XX0005X Orthopaedic Surgery
Specialization: Sports Medicine
33787 AZ Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WI 34952800 05

Other Providers JONATHAN MACK

NPI Name Taxonomy Address Enumeration
1922230747 Jonathan Frederick Mack Nurse Practitioner 6822 Lake Ct, San Diego, CA 92111-7023 2009-08-12
1346303161 Jonathan H. Mack Clinical Neuropsychologist 800 Denow Rd Ste S, Pennington, NJ 08534-5246 2006-12-19
1295784353 Jonathan Trimble Mack Counselor 7109 Prospect Pl Ne, Albuquerque, NM 87110-4313 2006-05-08

Office Location

Street Address 185 QUEEN CITY AVE
ELLIOT ORTHOPAEDIC SURGERY SPECIALISTS
City MANCHESTER
State NH
Zip Code 03101-7100

Providers in the same location

NPI Name Taxonomy Address Enumeration
1992700702 Stephen M. Wiener Internal Medicine 185 Queen City Ave, Manchester, NH 03101-7121 2005-06-17
1174140966 Patrick John Hammer Physical Therapist 185 Queen City Ave, Manchester, NH 03101-7121 2020-06-29
1144870601 Leah Hixon Nurse Practitioner 185 Queen City Ave, Manchester, NH 03101-7121 2019-09-17
1821565813 Kathryn Swegles Physician Assistant 185 Queen City Ave, Manchester, NH 03101-7121 2018-10-27
1679086839 Shannon Kelly Ward Nurse Practitioner 185 Queen City Ave, Manchester, NH 03101-7121 2017-11-09
1679085302 Marialaina Abbene Tomolonis Physician Assistant 185 Queen City Ave, Manchester, NH 03101-7121 2017-11-03
1225547268 Susan Marie Dionne Registered Nurse 185 Queen City Ave, Manchester, NH 03101-7121 2017-09-21
1649713827 Emily M Miller Physician Assistant 185 Queen City Ave, Manchester, NH 03101-7121 2016-11-21
1598211948 Jamie M. Gumb Physician Assistant 185 Queen City Ave, Manchester, NH 03101 2016-08-26
1447635263 Laura Kathryn Radlinski Physician Assistant 185 Queen City Ave, Manchester, NH 03101 2015-07-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1003320425 Miranda Sherburne Occupational Therapist 470 Pine Street, Manchester, NH 03101 2017-11-21
1396266938 Juliette W Daniels Social Worker 464 Chestnut Street, Child and Family Services, Manchester, NH 03101 2017-07-05
1851820450 Samantha Ysabelle Kattiria Specialist/Technologist 39 Kosciuszko Street, Apt 4, Manchester, NH 03101 2017-06-07
1598121188 Angelique Alicia Fortin Counselor 77 Pearl St., Manchester, NH 03101 2016-01-12
1578946786 Reta Goldman Counselor 25 Lowell St Ste 208, Manchester, NH 03101 2015-07-07
1306239207 Myra Jean Nikitas Dental Hygienist 97 West Merrimack Street, Manchester, NH 03101 2015-03-17
1902234586 Judith Patrick Ronshagen Pharmacist 175 Queen City Avenue, Ste 1, Manchester, NH 03101 2013-10-17
1942566336 Elizabeth Zavagnin Specialist 2 Wall St Ste 200, Manchester, NH 03101 2012-04-10
1538463088 William Gerald Mccormick Pharmacist 175 Queen City Ave, Manchester, NH 03101 2010-12-27
1215241799 Melissa Ann Dinoto Counselor 20 Market St., Manchester, NH 03101 2010-07-27
Find all providers in zip 03101

Taxonomy Information

Taxonomy Code 207XX0005X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery
Specialization Sports Medicine

Taxonomy Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639149073 Barry N. Messinger Orthopaedic Surgery 9 Bruce Rd, Manchester, CT 06040-7008 2006-01-26
1639570369 Seven Springs Orthopaedics and Sports Medicine Orthopaedic Surgery 1405 Hillsboro Blvd, Manchester, TN 37355-2107 2014-09-12
1770562407 Gregory W Soghikian Orthopaedic Surgery 700 Lake Ave, Suite One, Manchester, NH 03103-2734 2006-01-11

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1497722219 Mark C Cullen Orthopaedic Surgery 67 Corporate Dr, 2nd Fl, Portsmouth, NH 03801 2006-03-01
1619268646 Brendan Thomas Higgins Orthopaedic Surgery 264 Pleasant St, Concord, NH 03301 2011-04-25
1962663237 Tyler P Welch Orthopaedic Surgery 1900 Lafayette Rd, Suite A, Portsmouth, NH 03801-5679 2008-06-19
1942496377 Jason E Simon Orthopaedic Surgery 168 Kinsley St, Nashua, NH 03060-3634 2007-09-19
1225106818 John M Grobman Orthopaedic Surgery 14 Maple St, Suite 100, Gilford, NH 03249-6580 2006-12-01
1285643114 Kenneth J. Weintraub Orthopaedic Surgery 21 E Hollis St, Nashua, NH 03060-2928 2006-08-07
1760416234 Patrick J Casey Orthopaedic Surgery 264 Pleasant St, Concord, NH 03301-2551 2006-07-10
1306870860 Douglas J Moran Orthopaedic Surgery 264 Pleasant St, Concord, NH 03301-2551 2006-07-10
1487687364 John J O'connor Orthopaedic Surgery 264 Pleasant St, Concord, NH 03301-2551 2006-07-07
1518996214 Peter G Noordsij Orthopaedic Surgery 264 Pleasant St, Concord, NH 03301-2551 2006-07-03
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Competitor

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City MANCHESTER
Zip Code 03101

Improve Information

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Dataset Information

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.

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