KENDAL AT HANOVER I
NPI 1083756399
Skilled Nursing Facility in Hanover, NH

Active since February 13, 2007CLIA 30D0861325 · Waiver
80 LYME ROAD, HANOVER, NH 03755(603) 643-8900(603) 643-7099 Get Directions Write a Review

NPPES record last updated: April 27, 2017. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Kendal At Hanover I NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENDAL AT HANOVER I (NPI 1083756399) is a healthcare organization registered as a skilled nursing facility in Hanover, New Hampshire and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Brent B Edgerton, Associate Executive Director, as its authorized official.

NPPES Registry Identity

NPI1083756399
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameKENDAL AT HANOVER I
Location Address80 LYME ROADHanover, NH 03755
Mailing Address80 Lyme RoadHanover, NH 03755 · (603) 643-8900 · Fax (603) 643-7099
Fax(603) 643-7099
Organization SubpartNo
Authorized OfficialBrent B EdgertonAssociate Executive Director · (603) 643-7004
Enumeration DateFebruary 13, 2007
Last NPPES UpdateApril 27, 2017
NPI 1083756399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in NH · 01775
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Also ListedPhysical TherapistTaxonomy 225100000X
Also ListedOccupational TherapistTaxonomy 225X00000X
Also ListedAssisted Living FacilityTaxonomy 310400000X · License 01954 (NH)
80 LYME ROAD, Hanover, NH 03755

Other Identifiers 1

Medicare OSCAR/certification305042NH

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 30D0861325

Kendal At Hanover · Hanover, NH
Active · expires Aug 31, 2026
CLIA Number30D0861325
Laboratory TypeAssisted Living Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRebecca M. Wood
Laboratory Phone(603) 653-8505
Laboratory LocationKendal At Hanover67 Cummings Rd, Hanover, NH 03755
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
80 LYME ROAD, KENDAL AT HANOVER
HANOVER, NH 03755

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kendal At Hanover I's NPI number?

The NPI number for Kendal At Hanover I is 1083756399. It was assigned to this organization in the NPPES registry on February 13, 2007.

Where is Kendal At Hanover I located?

Kendal At Hanover I is located at 80 Lyme Road, Hanover, NH 03755. The listed phone number is (603) 643-8900.

What is Kendal At Hanover I's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Kendal At Hanover I hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 30D0861325) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kendal At Hanover I was last updated on April 27, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.