DR. RANDALL CLARK FENTON (NPI# 1629077359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629077359 |
| Entity Type | Individual |
| Full Name | DR. RANDALL CLARK FENTON |
| Credential | M.D. |
| Practice Address |
29 Stiles Rd Suite 301 Salem NH 03079-5802 |
| Practice Telephone | 6038705452 |
| Practice Fax Number | 6038705449 |
| Mailing Telephone | 6038705452 |
| Mailing Fax Number | 6038705449 |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2016-02-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 9962 | NH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ANTHEM BCBS NEW HAMPSHIRE | 0100419YPNH01 | 01 | |
| UNIFORMED SERVICES FAMILY | 407866 | 01 | |
| HARVARD PILGRIM HEALTHCAR | 71838 | 01 | |
| TUFTS HEALTHPLAN | 753299 | 01 | |
| BCBS OF MASSACHUSETTS | J17896 | 01 | |
| CIGNA | 66951 | 01 | |
| AETNA | 2637002 | 01 |
| Street Address |
29 STILES RD SUITE 301 |
| City | SALEM |
| State | NH |
| Zip Code | 03079-5802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245548353 | Spinemed Decompression Therapy of Southern New Hampshire | Specialist/Technologist, Other | 29 Stiles Rd, Ste 202, Salem, NH 03079-5802 | 2010-09-23 |
| 1548430077 | Rehab Associates of New England | Radiology | 29 Stiles Rd, Salem, NH 03079-5802 | 2008-03-12 |
| 1073796926 | Rehab Associates of New England | Radiology | 29 Stiles Rd, Salem, NH 03079 | 2007-12-14 |
| 1467441923 | Orthopaedics Northeast, P.C. | Internal Medicine | 29 Stiles Rd, Suite 102, Salem, NH 03079-2859 | 2005-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689156945 | Susan Lou Harris | Social Worker | 56 Zion Hill Rd, Salem, NH 03079 | 2018-09-04 |
| 1861970972 | Norrine Mcnelley | Nurse Practitioner | 25 Beechwood Rd, Salem, NH 03079 | 2018-07-31 |
| 1275024135 | Rhode Island Optometrics, LLC | Optometrist | 42 Samoset Dr, Salem, NH 03079 | 2018-05-25 |
| 1003338666 | Rachel Blazich | Specialist/Technologist | 25 General Pulaski Drive, Salem, NH 03079 | 2017-07-14 |
| 1902327935 | Brenda Michelle Karibian | Nurse Practitioner | 9 Gardner Ave, Salem, NH 03079 | 2017-06-29 |
| 1730559154 | Jessica Meredith Cooper | Naturopath | 23 Stiles Rd Ste 210, Salem, NH 03079 | 2015-09-28 |
| 1659754257 | Shuja U Saleem, M.d. | Obstetrics & Gynecology | 23 Stiles Rd., #217, Salem, NH 03079 | 2015-07-01 |
| 1457739724 | Marisa O'brien | Registered Nurse | 2 Keewayin Drive, Salem, NH 03079 | 2015-05-07 |
| 1215360805 | Jeffrey Malone | Counselor | 103 Cluff Crossing, P-3, Salem, NH 03079 | 2013-08-19 |
| 1184964546 | Larissa Grace Pickett | Specialist | 195 North Broadway, Salem Sports and Rehab, Salem, NH 03079 | 2013-02-21 |
| Find all providers in zip 03079 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710373444 | Larry Bassinger | Family Medicine | 1300 Broadway St Ne Ste 104, Salem, OR 97301-1420 | 2015-04-09 |
| 1396144507 | Constance Johanson | Family Medicine | 3959 Croisan Creek Rd S, Salem, OR 97302-9474 | 2014-08-14 |
| 1457792699 | Sultan Seretis Bussey Hospitalist LLC | Family Medicine | 310 Route 45, Salem, NJ 08079-2064 | 2013-07-16 |
| 1629338470 | Derek Koller | Family Medicine | 6861 Lemongrass Loop Se, Salem, OR 97306-1474 | 2012-05-25 |
| 1962712927 | Paul Julian Perrin | Family Medicine | 525 Ferry St Se, Suite 203, Salem, OR 97301 | 2010-10-08 |
| 1326372558 | Robert Verne Bain | Family Medicine | 2280 Kuebler Road, South, Salem, OR 97302 | 2009-09-21 |
| 1902036320 | James A. Auerbach, M.d., P.C. | Family Medicine | 4747 Skyline Rd S, Suite 190, Salem, OR 97306-4200 | 2009-07-20 |
| 1033347430 | Jeanette Walker | Family Medicine | 5560 Witzel Rd Se, Salem, OR 97317-9142 | 2009-06-24 |
| 1871747188 | Carmelle Marie Andrine Constant | Family Medicine | 84 Highland Ave Ste 309, Salem, MA 01970-2733 | 2008-11-13 |
| 1518127927 | Mazen I Madhoun | Family Medicine | 3737 W Main St Ste 101, Salem, VA 24153-2073 | 2008-06-10 |
| Find all providers in SALEM | ||||
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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.