UPPER VALLEY NEUROLOGY NEUROSURGERY,PC - NPI 1174620363

Q: What is the provider's specialty?

The provider's specialty is Specialist with taxonomy code 174400000X.

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About Upper Valley Neurology Neurosurgery,pc NPPES

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

UPPER VALLEY NEUROLOGY NEUROSURGERY,PC (NPI 1174620363) is a healthcare organization registered as a specialist in Lebanon, New Hampshire and active in the NPI registry since September 2006. The organization lists Donald W Ayres, President, as its authorized official.

NPPES Registry Identity

NPI1174620363

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameUPPER VALLEY NEUROLOGY NEUROSURGERY,PC

Location Address106 HANOVER STLebanon, NH 03766-1042

Mailing Address106 Hanover StLebanon, NH 03766-1042 · (603) 448-0447 · Fax (603) 448-1089

Phone(603) 448-0447

Fax(603) 448-1089

Organization SubpartNo

Authorized OfficialDonald W AyresPresident · (603) 448-0447

Enumeration DateSeptember 20, 2006

Last NPPES UpdateJanuary 20, 2010

✔ NPI 1174620363 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

106 HANOVER ST, Lebanon, NH 03766

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Other Identifiers 2

Medicare ID-Type UnspecifiedRE3504NH · Group Provider Number

Medicaid800003504NH

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 30D0995404

Upper Valley Neurology Neurosurgery · Lebanon, NH

Expired · Jan 17, 2026

CLIA Number30D0995404

Laboratory TypePhysician Office

Certificate Effective DateJanuary 18, 2024

Certificate Expiration DateJanuary 17, 2026

Laboratory DirectorDonald W. Ayres MD

Laboratory Phone(603) 448-0447

Laboratory LocationUpper Valley Neurology Neurosurgery106 Hanover Street, Lebanon, NH 03766

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

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

DR. JENNIFER H. JUDKINS M.D.

Specialist