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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

EDEN INTEGRATIVE MEDICINE PLLC
NPI 1417864380
Family Medicine in Gilsum, NH

Active since August 26, 2026CLIA 30D2352199 · Waiver

NPPES record added: August 26, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Eden Integrative Medicine Pllc NPPES

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

EDEN INTEGRATIVE MEDICINE PLLC (NPI 1417864380) is a healthcare organization registered as a family medicine in Gilsum, New Hampshire and active in the NPI registry since August 2026. The organization holds a CLIA Waiver certificate valid through October 11, 2028 and lists Audra J. Wilson, Manager/owner, as its authorized official.

NPPES Registry Identity

NPI1417864380
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEDEN INTEGRATIVE MEDICINE PLLC
Location Address626 RT. 10Gilsum, NH 03448
Mailing Address135 Silent WayKeene, NH 03431-4739 · (603) 338-8757
Phone(603) 338-8757
Organization SubpartNo
Authorized OfficialAudra J. WilsonManager/owner · (603) 338-8757
Enumeration DateAugust 26, 2026
NPPES CertifiedAugust 21, 2026
✔ NPI 1417864380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
626 RT. 10, Gilsum, NH 03448
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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 30D2352199

Eden Integrative Medicine PLLC · Gilsum, NH
Active · expires Oct 11, 2028
CLIA Number30D2352199
Laboratory TypeCommunity Clinic
Certificate Effective DateOctober 12, 2026
Certificate Expiration DateOctober 11, 2028
Laboratory DirectorAudra J. Wilson
Laboratory Phone(603) 338-8757
Laboratory LocationEden Integrative Medicine PLLC626 Rt 10, Gilsum, NH 03448
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Eden Integrative Medicine PLLC's NPI number?

The NPI number for Eden Integrative Medicine PLLC is 1417864380. It was assigned to this organization in the NPPES registry on August 26, 2026.

Where is Eden Integrative Medicine PLLC located?

Eden Integrative Medicine PLLC is located at 626 Rt. 10, Gilsum, NH 03448. The listed phone number is (603) 338-8757.

What is Eden Integrative Medicine PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Eden Integrative Medicine PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 30D2352199) is associated with this NPI, valid through October 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Eden Integrative Medicine PLLC was last updated on August 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.