Wild Prairie Primary Care PLLC
NPI 1720961865ActiveOrganization· Internal Medicine· Lebanon, NH
Internal Medicine in Lebanon, New Hampshire, registered in NPPES in July 2025. The authorized official on file is Juniper Vale, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1720961865 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 28, 2025 |
| Last updated in NPPES | Oct 18, 2025 |
| Certified by provider | Oct 18, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NH) |
|---|
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