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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 34952800 | 05 |
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 |
Street Address |
185 QUEEN CITY AVE ELLIOT ORTHOPAEDIC SURGERY SPECIALISTS |
City | MANCHESTER |
State | NH |
Zip Code | 03101-7100 |
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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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 Code | 207XX0005X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Sports Medicine |
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 |
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 |
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 |
Find all providers with the same taxonomy |
City | MANCHESTER |
Zip Code | 03101 |
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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.