DR. JAMES M MACNUTT (NPI# 1760618862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760618862 |
| Entity Type | Individual |
| Full Name | DR. JAMES M MACNUTT |
| Credential | DO |
| Practice Address |
417 State Street Webber East Building Suite 221 Bangor ME 04401 |
| Mailing Address |
43 Whiting Hill Rd Ste 300 Brewer ME 04412-1006 |
| Practice Telephone | 2079739949 |
| Practice Fax Number | 2079739555 |
| Mailing Telephone | 2079735000 |
| Mailing Fax Number | 2079735042 |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2020-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | DO2118 | ME | Allopathic & Osteopathic Physicians |
| N | 207T00000X | Neurological Surgery | 53946 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
417 STATE STREET WEBBER EAST BUILDING SUITE 221 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790765329 | Christine Mary Fink | Clinical Neuropsychologist | 417 State Street, Webber East, Suite 209, Bangor, ME 04401 | 2006-01-19 |
| 1083215404 | Ahmed Messahel | Oral & Maxillofacial Surgery | 417 State Street, Webber West Suite 340, Bangor, ME 04441-6630 | 2020-11-03 |
| 1417580754 | Nicholas John Liska | Orthopaedic Surgery | 417 State Street, Suite 340, Webber West, Bangor, ME 04401 | 2020-02-14 |
| 1356809883 | Abigail Elizabeth Bobbitt | Physician Assistant | 417 State Street, Webber West, Suite 443, Bangor, ME 04401 | 2019-03-04 |
| 1740732478 | Gabrielle Ingerson | Physician Assistant | 417 State Street, Bangor, ME 04401 | 2016-10-28 |
| 1780098236 | Farwa Batool | Surgery | 417 State Street, Suite 340, Webber West, Bangor, ME 04401-6634 | 2014-06-12 |
| 1992069058 | Jenifer L Mckenney | Nurse Practitioner | 417 State Street, Webber West Suite 141, Bangor, ME 04401 | 2012-07-03 |
| 1881968543 | Rudolph Daniel Marciano IIi | Neurological Surgery | 417 State Street, Webber East, Ste 221, Bangor, ME 04401 | 2012-02-28 |
| 1932335940 | Marilyn Joy Erickson | Genetic Counselor, MS | 417 State Street, Suite 305, Bangor, ME 04401 | 2009-06-04 |
| 1811041437 | Diane Marion Reynolds | Physician Assistant | 417 State Street, Webber East, Suite 310, Bangor, ME 04401-1000 | 2007-01-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
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| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962446724 | Northeast Neurosurgery, P.a. | Neurological Surgery | 498 Essex St, Suite 104, Bangor, ME 04401-3990 | 2006-06-15 |
| 1447248802 | James W Turner | Neurological Surgery | 417 State St Ste 221, Bangor, ME 04401-6630 | 2005-10-10 |
| 1689104234 | Michael Paci | Neurological Surgery | 417 State St Ste 221, Bangor, ME 04401 | 2017-06-15 |
| 1881968543 | Rudolph Daniel Marciano IIi | Neurological Surgery | 417 State Street, Webber East, Ste 221, Bangor, ME 04401 | 2012-02-28 |
| 1730479817 | Michael Cohen | Neurological Surgery | 417 State St Ste 221, Bangor, ME 04401-6630 | 2011-04-11 |
| 1457528010 | Mahmoud Hamdy Ibrahim Kamel | Neurological Surgery | 489 State Street, Eastern Maine Medical Center / Dept. of Neurosurgery, Bangor, ME 04401 | 2008-05-13 |
| 1275626814 | Dennis Lee Shubert | Neurological Surgery | 404 State St, Suite 101, Bangor, ME 04401 | 2006-10-02 |
| 1689620775 | Joanna R Swartzbaugh | Neurological Surgery | 360 Broadway, Bangor, ME 04401-3979 | 2006-05-26 |
| 1891783254 | David M Weitman | Neurological Surgery | 360 Broadway, Bangor, ME 04401-3979 | 2005-10-10 |
| 1457359226 | Wayne Robert Waterman | Neurological Surgery | 417 State St, Suite 221, Bangor, ME 04401-6630 | 2005-07-14 |
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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.