Wild Prairie Primary Care PLLC
NPI 1720961865 · Internal Medicine Physician · Lebanon, NH
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Wild Prairie Primary Care PLLC is a Internal Medicine Physician organization in Lebanon, NH (NPI 1720961865).
Provider details
- NPI number
- 1720961865
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Juniper Vale, Owner(603) 727-9175
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-07-28
- Last updated
- 2025-10-18
- Certified
- 2025-10-18
Frequently asked questions
- What is Wild Prairie Primary Care PLLC's NPI number?
- Wild Prairie Primary Care PLLC's National Provider Identifier (NPI) is 1720961865, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Wild Prairie Primary Care PLLC?
- Wild Prairie Primary Care PLLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Wild Prairie Primary Care PLLC located?
- Wild Prairie Primary Care PLLC's practice location on file with NPPES is 240 Mechanic St Ste 201, Lebanon, NH 03766-2617.
- What is Wild Prairie Primary Care PLLC's phone number?
- The practice phone number listed in the NPPES registry for Wild Prairie Primary Care PLLC is (971) 235-9657.
- Does Wild Prairie Primary Care PLLC accept Medicare?
- Wild Prairie Primary Care PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Wild Prairie Primary Care PLLC?
- The authorized official listed on Wild Prairie Primary Care PLLC's NPPES record is Juniper Vale, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Wild Prairie Primary Care PLLC's NPI active?
- Yes — Wild Prairie Primary Care PLLC's NPI (1720961865) is active in the NPPES registry as of the last update on 2025-10-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.