SANDRA BAGWELL (NPI# 1659586048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659586048 |
| Entity Type | Individual |
| Full Name | SANDRA BAGWELL |
| Credential | MD |
| Practice Address |
22 Bramhall St Portland ME 04102 |
| Mailing Address |
190 Riverside St Suite 6b Portland ME 04103-1073 |
| Practice Telephone | 2076622179 |
| Practice Fax Number | 2076626326 |
| Mailing Telephone | 2076612000 |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2017-04-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
012416 | ME | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 284390099 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801830880 | Sandra Lee Bagwell | Registered Nurse | 21750 Sacramento Ave, Red Bluff, CA 96080-7743 | 2006-06-16 |
| Street Address |
22 BRAMHALL ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641355 | Suzanne Maynard | Specialist | 22 Bramhall St, Dept of Anesthesiology, Portland, ME 04102 | 2005-07-05 |
| 1902406135 | Barbara Lewis-armstrong | Social Worker | 22 Bramhall St, Portland, ME 04102-3175 | 2020-10-27 |
| 1285231217 | Malia Haddock | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-10-02 |
| 1972118222 | Morgan O'brien | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-09-14 |
| 1295349900 | Natalie Margaret Petrone | Occupational Therapist | 22 Bramhall St, Portland, ME 04102-3175 | 2020-09-01 |
| 1467065565 | Mandi Ann Horwath | Nurse Practitioner | 22 Bramhall St, Portland, ME 04102-3134 | 2020-08-28 |
| 1922610492 | Diana Christine Hubbell | Registered Nurse | 22 Bramhall St, Portland, ME 04102-3134 | 2020-08-17 |
| 1790393023 | Rami Waked | Student in an Organized Health Care Education/Training Program | 22 Bramhall St, Portland, ME 04102-3134 | 2020-07-22 |
| 1871117143 | Lesley Raley | Pharmacist | 22 Bramhall St, Portland, ME 04102-3134 | 2020-06-03 |
| 1023638707 | Rebecca Naomi Glass | Physical Therapist | 22 Bramhall St, Portland, ME 04102-3134 | 2020-04-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
| 1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
| 1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1376074674 | Samuel B Potter | Emergency Medicine | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2017-03-27 |
| 1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
| Find all providers in zip 04102 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548587660 | Anna Kristin Brady | Internal Medicine | 3181 Sw Sam Jackson Park Rd # 67, Portland, OR 97239-3011 | 2010-04-29 |
| 1699869255 | Ralph A Juarez | Internal Medicine | 10201 Se Main St Ste 11, Portland, OR 97216-2937 | 2006-10-03 |
| 1285731059 | Catherine J Markin | Internal Medicine | 2222 Nw Lovejoy St., Mob 1 Suite 411, Portland, OR 97210 | 2006-09-20 |
| 1477520120 | Poh Hock Leng | Internal Medicine | 2222 Nw Lovejoy St Ste 411, Portland, OR 97210-5102 | 2006-03-01 |
| 1174918890 | Providence Health & Services - Oregon | Internal Medicine | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2015-03-31 |
| 1184034399 | Matthew Miller | Internal Medicine | 3181 Sw Sam Jackson Park Rd # Uhn67, Portland, OR 97239-3079 | 2014-04-28 |
| 1497098602 | Tony Adams | Internal Medicine | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2013-04-05 |
| 1598054132 | Peter Jackson | Internal Medicine | 2222 Nw Lovejoy St, #411, Portland, OR 97210-3033 | 2011-04-05 |
| 1497910210 | Lianne Liang-jung Lin | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6652 | 2008-07-21 |
| 1720264476 | Hataya Kristy Poonyagariyagorn | Internal Medicine | 9427 Sw Barnes Rd Ste 296, Portland, OR 97225-6667 | 2008-01-11 |
| 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.