DFD RUSSELL MEDICAL CENTER INC (NPI# 1528377454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528377454 |
| Entity Type | Organization |
| Organization Name | DFD RUSSELL MEDICAL CENTER INC |
| Practice Address |
11 Academy Rd Monmouth ME 04259-7035 |
| Mailing Address |
180 Church Hill Rd Ste 1 Leeds ME 04263-3418 |
| Practice Telephone | 2079339646 |
| Practice Fax Number | 2079339645 |
| Mailing Telephone | 2075243501 |
| Mailing Fax Number | 2075242459 |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2011-06-07 |
| Authorized Official Name | LAURIE A KANE-LEWIS (CEO) |
| Authorized Official Telephone | 2075243501 |
| Is Organization Subpart | Y |
| Parent Organization Name | DFD RUSSELL MEDICA CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
ME | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 168270000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881903714 | Dfd Russell Medical Center Inc | Clinic/Center | 7 Main St, Turner, ME 04282-4138 | 2010-09-27 |
| 1952482804 | Dfd Russell Medical Center Inc | Clinic/Center | 180 Church Hill Rd, Suite 1, Leeds, ME 04263-3418 | 2006-10-18 |
| Street Address |
11 ACADEMY RD |
| City | MONMOUTH |
| State | ME |
| Zip Code | 04259-7035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245208289 | John M Yindra | Family Medicine | 11 Academy Rd, Monmouth, ME 04259-7035 | 2006-03-08 |
| 1316496052 | Kassie A Skvorak | Physician Assistant | 11 Academy Rd, Monmouth, ME 04259-7035 | 2016-09-22 |
| 1073984225 | Julie Gerow | Nurse Practitioner | 11 Academy Rd, Monmouth, ME 04259-7035 | 2015-10-14 |
| 1861773749 | Nora Jeanne Gross | Social Worker | 11 Academy Rd, Monmouth, ME 04259-7035 | 2011-09-06 |
| 1427338698 | Anthony S Martin | Physician Assistant | 11 Academy Rd, Monmouth, ME 04259-7035 | 2011-08-19 |
| 1912299397 | Megan Marie Hutchins | Social Worker | 11 Academy Rd, Monmouth, ME 04259-7035 | 2011-05-04 |
| 1568799831 | Jodie B Kaufman | Nurse Practitioner | 11 Academy Rd, Monmouth, ME 04259-7035 | 2009-11-07 |
| 1023195633 | Lindsay S Harnden | Physician Assistant | 11 Academy Rd, Monmouth, ME 04259-7035 | 2006-11-01 |
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|---|---|---|---|---|
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| 1477984755 | Jamey Roy Cotnoir | Occupational Therapist | 15 Chick Dr., Monmouth, ME 04259 | 2013-12-11 |
| 1013960673 | Monmouth Rescue Association, Inc | Ambulance | 847 Main St, Monmouth, ME 04259 | 2006-05-17 |
| 1871558171 | Core Physical Therapy, Pa | Physical Therapist | 392 Route 202, Monmouth, ME 04259 | 2006-04-19 |
| 1588990550 | Anna Mcelhaney | Occupational Therapy Assistant | 392 Us Route 202, Monmouth, ME 04259 | 2009-10-27 |
| 1518171396 | Spectrum Occupational Therapy Services | Occupational Therapist | 392 Us Route 202, Monmouth, ME 04259 | 2007-05-10 |
| 1619105723 | Joyce Lagasse | In Home Supportive Care | 50 Morrill Ln, Monmouth, ME 04259-6416 | 2009-06-26 |
| 1376659342 | Roberta Jacqueline Mullan | Counselor | 256 Cressey Rd, Monmouth, ME 04259-6804 | 2006-08-22 |
| 1639352057 | David W. Varney, Dc, Pa | Chiropractor | 6 Blue Rd, Monmouth, ME 04259-6901 | 2007-12-07 |
| 1790101855 | Jessica J Belanger | Massage Therapist | 6 Blue Rd, Monmouth, ME 04259-6901 | 2014-03-13 |
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| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1760973960 | Penobscot Community Health Center | Clinic/Center | 1012 Union St Ste 3, Bangor, ME 04401-3058 | 2018-05-23 |
| 1700317971 | Portland Community Health Center | Clinic/Center | 28 Portland St, Portland, ME 04101-2912 | 2017-03-21 |
| 1184165367 | Katahdin Valley Health Center | Clinic/Center | 65 South St, Houlton, ME 04730-1550 | 2017-03-20 |
| 1255872537 | Portland Community Health Center | Clinic/Center | 175 Auburn St, Portland, ME 04103-2131 | 2017-03-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.