Healthcare Provider Details

I. General information

NPI: 1033466784
Provider Name (Legal Business Name): KEADY FAMILY PRACTICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2012
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 WASHINGTON ST
CLAREMONT NH
03743-5512
US

IV. Provider business mailing address

214 WASHINGTON ST
CLAREMONT NH
03743-5512
US

V. Phone/Fax

Practice location:
  • Phone: 603-863-7777
  • Fax: 603-769-3406
Mailing address:
  • Phone: 603-863-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number052532-23
License Number StateNH

VIII. Authorized Official

Name: MR. JAMES PATRICK KEADY JR.
Title or Position: PRACTICE MANAGER
Credential:
Phone: 603-826-3434