DR. AVIVA D WERTKIN (NPI# 1649444951) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649444951 |
Entity Type | Individual |
Full Name | DR. AVIVA D WERTKIN |
Credential | ND NATUROPATHIC DOCT |
Practice Address |
222 Auburn St Ste 102 Portland ME 04103-6005 |
Practice Telephone | 2078990540 |
Practice Fax Number | 2078990546 |
Mailing Telephone | 2078990540 |
Mailing Fax Number | 2078990546 |
Enumeration Date | 2008-04-17 |
Last Update Date | 2020-03-09 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 175F00000X | Naturopath | 099.0100226 | VT | Other Service Providers |
N | 207Q00000X | Family Medicine | 099.0100226 | VT | Allopathic & Osteopathic Physicians |
Y | 208D00000X | General Practice | NP624 | ME | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ANTHEM BLUE CROSS | 110000384CT01 | 01 | |
CAQH NUMBER | 11805577 | 01 |
Street Address |
222 AUBURN ST STE 102 |
City | PORTLAND |
State | ME |
Zip Code | 04103-6005 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477045961 | Sisu Chiro Pllc | Chiropractor | 222 Auburn St Ste 102, Portland, ME 04103 | 2018-05-31 |
1649679457 | Benjamin James Goudreau | Chiropractor | 222 Auburn St Ste 102, Portland, ME 04103-6005 | 2014-08-18 |
1881977064 | Jesse Carmen Mead | Chiropractor | 222 Auburn St Ste 102, Portland, ME 04103 | 2011-09-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
1982251435 | Hope Home Healthcare, LLC | Home Health | 68 Bishop St Unit 3 #2, Portland, ME 04103 | 2019-08-20 |
1992367023 | Care for Everyone | In Home Supportive Care | 68 Bishop Street, Unit 1, Room 5, Portland, ME 04103 | 2019-06-28 |
1093373458 | Emanuel Nistrian | Student in an Organized Health Care Education/Training Program | Une, 716 Stevens Ave., Portland, ME 04103 | 2019-05-31 |
1023676483 | Robert Montague | Student in an Organized Health Care Education/Training Program | University of New England, 716 Stevens Ave, Portland, ME 04103 | 2019-05-31 |
1154838027 | Kimberly Therriault | Behavior Technician | 527 Ocean Ave Ste 19, Portland, ME 04103 | 2018-01-02 |
1285147918 | Teresa Maalouf | Community Health Worker | 23 Cambridge St., Portland, ME 04103 | 2017-11-16 |
1578082244 | Darcelle Kay Stillman | Occupational Therapist | 90 Dorothy St, Portland, ME 04103 | 2017-09-14 |
1821524943 | Engility Enterprises LLC | Case Management | 1 Coast Lane, Portland, ME 04103 | 2017-05-10 |
1720524283 | Hannah Rose Kazilionis | Counselor | 257 Deering Ave # 204, Portland, ME 04103 | 2017-01-09 |
Find all providers in zip 04103 |
Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
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1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
1346751443 | Providence Health & Services Oregon | General Practice | 4400 Ne Halsey St, Pop 2, 3rd Floor, Portland, OR 97213-1545 | 2017-10-16 |
1336697143 | Rita Lawler | General Practice | 8353 Se Clatsop Ct, Portland, OR 97266-6159 | 2016-09-21 |
1235526849 | Hollis Lule Augee | General Practice | 5151 S.w. 88th Ave., Portland, OR 97225-1717 | 2015-04-21 |
1093134496 | Red Leaf Natural Health Clinic | General Practice | 833 Sw 11th Ave Ste 1018, Portland, OR 97205-2124 | 2014-04-14 |
1861770190 | Jeffrey Owen Pentecost | General Practice | 3574 Se Harold Ct, Portland, OR 97202-4344 | 2011-08-03 |
1255651592 | Nic Group Inc | General Practice | 8383 Ne Sandy Blvd Ste 320dd, Portland, OR 97220-4968 | 2010-06-09 |
1619296985 | Thcf | General Practice | 105 Se 18th Ave, Portland, OR 97214-1559 | 2010-05-25 |
1518106640 | Keith C Klopfer | General Practice | 1601 Sw Pendleton St, Portland, OR 97239-2619 | 2009-02-12 |
1275793424 | Harriet Cooke | General Practice | 2929 Sw Multnomah Blvd Ste 301, Portland, OR 97219-4072 | 2008-06-11 |
Find all providers in PORTLAND |
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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.