PORT CITY PHYSICAL THERAPY (NPI# 1740248996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740248996 |
| Entity Type | Organization |
| Organization Name | PORT CITY PHYSICAL THERAPY |
| Practice Address |
94 Auburn St Suite 103 Port City Physical Therapy Portland ME 04106 |
| Mailing Address |
94 Auburn St Suite 103 Portland ME 04103 |
| Practice Telephone | 2077977578 |
| Practice Fax Number | 2077978165 |
| Mailing Telephone | 2077977578 |
| Mailing Fax Number | 2077978165 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT J SULLIVAN (ATHLETIC TRAINER) |
| Authorized Official Telephone | 6175155915 |
| Authorized Official Credential | M ED ATC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT233 | ME | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932354735 | Port City Physical Therapy | Clinic/Center | 1242 Anchor Dr, Mobile, AL 36693-4500 | 2008-11-20 |
| Street Address |
94 AUBURN ST SUITE 103 PORT CITY PHYSICAL THERAPY |
| City | PORTLAND |
| State | ME |
| Zip Code | 04106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205805967 | Guy Robert Audet | Physical Therapy Assistant | 94 Auburn St, Suite 3, Portland, ME 04103 | 2006-03-15 |
| 1689073538 | Kimberley Brewster | Registered Nurse | 94 Auburn St, Suite 205, Portland, ME 04103-2141 | 2014-08-16 |
| 1134530066 | Noble Home Health Care, Inc. | Home Health | 94 Auburn St, Suite 205, Portland, ME 04103-2141 | 2014-05-13 |
| 1255764817 | Connor J Simpson | Physical Therapist | 94 Auburn St, Suite 103, Portland, ME 04103-2141 | 2013-08-18 |
| 1205155611 | Osteopathic Wellness LLC | Neuromusculoskeletal Medicine & OMM | 94 Auburn St, Suite 106, Portland, ME 04103-2141 | 2010-05-25 |
| 1851543177 | Port City Physical Therapy Limited Partnership | Durable Medical Equipment & Medical Supplies | 94 Auburn St, Ste 3, Portland, ME 04103-2141 | 2008-10-17 |
| 1023147733 | Michael L Buzzell | Contractor | 94 Auburn St, Portland, ME 04103-2141 | 2007-03-06 |
| 1841381290 | Port City Physical Therapy Limited | Physical Therapist | 94 Auburn St, Suite 3, Portland, ME 04103-2141 | 2006-09-28 |
| 1306953450 | Shawn M Higgins | Neuromusculoskeletal Medicine & OMM | 94 Auburn St, Suite 106, Portland, ME 04103-2141 | 2006-08-24 |
| 1033166939 | Wendy A Richards | Physical Therapist | 94 Auburn St, Suite 3, Portland, ME 04103-2141 | 2006-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513748 | Rayna Louise Sage | Behavior Technician | 50 Donald Beaver Drrive, Ste B, Portland, ME 04106 | 2020-09-17 |
| 1972127330 | Scott M Davis Md LLC | Internal Medicine | 89 Cannon Road, South Portland, ME 04106 | 2020-06-02 |
| 1568013936 | Clara Cassidy | Behavior Technician | 50 Donald Bean Dr, Ste B, South Portland, ME 04106 | 2019-09-26 |
| 1336614346 | Kari Whitney | Nurse Practitioner | Vna Home Health Hospice, 50 Foden Road, Suite 1, South Portland, ME 04106 | 2018-10-05 |
| 1588152193 | Kristen F. Pierce | Counselor | 100 Waterman Drive, Suite 201, South Portland, ME 04106 | 2018-04-30 |
| 1649779224 | Jennifer Rene Johnson | Social Worker | 135 Westbrook St, South Portland, ME 04106 | 2018-02-08 |
| 1154847721 | Integral Nutrition, LLC | Dietitian, Registered | 59 Baltimore Avenue, South Portland, ME 04106 | 2017-08-16 |
| 1730619610 | John Preston Powell | Psychiatry & Neurology | 68 B Street Apt 4, South Portland, ME 04106 | 2017-06-14 |
| 1649706268 | Gisselle Mani | Student in an Organized Health Care Education/Training Program | 30 Lydia Ln Apt 2115, South Portland, ME 04106 | 2017-05-02 |
| 1245786987 | Jonathan Frank Olmes | Optometrist | 335 Maine Mall Rd., South Portland, ME 04106 | 2016-09-01 |
| Find all providers in zip 04106 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639782550 | Madeleine Vivian Reid | Specialist/Technologist | 204 Maine Ave, Portland, ME 04103-3906 | 2020-08-29 |
| 1154933158 | Jennifer Owens | Specialist/Technologist | 2 Jobs Gate 1, Portland, CT 06480-1750 | 2020-08-20 |
| 1083232847 | Bailey Michelle Allen | Specialist/Technologist | 3521 Ne 154th Ave, Portland, OR 97230-4677 | 2020-07-08 |
| 1568097061 | Rob Gersky | Specialist/Technologist | 2712 Se 170th Ave, Portland, OR 97236-1215 | 2020-03-05 |
| 1922630037 | Vanessa A Guerrero | Specialist/Technologist | 2219 Se 68th Ave # 410, Portland, OR 97215-4026 | 2020-02-06 |
| 1386284453 | Richard J Campbell | Specialist/Technologist | 300 N Winning Way, Portland, OR 97227-2108 | 2020-01-07 |
| 1417597584 | Sarah Ashley Mcsweeney | Specialist/Technologist | 2105 Nw Flanders St Apt 4, Portland, OR 97210-3450 | 2020-01-07 |
| 1629617402 | Roger A Doak | Specialist/Technologist | 1100 Ionia Rd, Portland, MI 48875-1035 | 2019-12-27 |
| 1366096448 | Madeleine Knutson | Specialist/Technologist | 12617 Nw Avignon Ln, Portland, OR 97229-9405 | 2019-07-28 |
| 1720648215 | Nicholas Ryan Thomas | Specialist/Technologist | 4800 Ne 122nd Ave, Portland, OR 97230-1001 | 2019-06-17 |
| 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.