PENOBSCOT NATION HEALTH DEPARTMENT (NPI# 1801101993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801101993 |
| Entity Type | Organization |
| Organization Name | PENOBSCOT NATION HEALTH DEPARTMENT |
| Practice Address |
23 Wabanaki Way Indian Island ME 04468-1252 |
| Practice Telephone | 2078177400 |
| Practice Fax Number | 2078177459 |
| Mailing Telephone | 2078177400 |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |
| Authorized Official Name | JILL P MACDOUGALL (INTERN DIRECTOR) |
| Authorized Official Telephone | 2078177404 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 12011471A | IN | Ambulatory Health Care Facilities |
| Street Address |
23 WABANAKI WAY |
| City | INDIAN ISLAND |
| State | ME |
| Zip Code | 04468-1252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679578025 | Leslie Maxwell Ohmart IIi | Pharmacist | 23 Wabanaki Way, Indian Island, ME 04468-1252 | 2005-06-14 |
| 1700293057 | Crystal Sutton | Nurse Practitioner | 23 Wabanaki Way, Indian Island, ME 04468-1252 | 2014-07-18 |
| 1013187061 | Paul Dean Flagg | Pharmacist | 23 Wabanaki Way, Indian Island, ME 04468-1252 | 2008-03-06 |
| 1922206408 | Nadine Villani | Nurse Practitioner | 23 Wabanaki Way, Indian Island, ME 04468-1252 | 2007-07-06 |
| 1467658112 | Benjamin Walter Huerth | Family Medicine | 23 Wabanaki Way, Indian Island, ME 04468-1252 | 2007-06-21 |
| 1568673267 | Merla Roy | Technician, Pathology | 23 Wabanaki Way, Indian Island, ME 04468 | 2007-05-24 |
| 1225153851 | Margo Downing | Registered Nurse | 23 Wabanaki Way, Indian Island, ME 04468 | 2007-03-20 |
| 1033277678 | Tanya M Miller | Registered Nurse | 23 Wabanaki Way, Indian Island, ME 04468-1252 | 2006-12-05 |
| 1457427841 | Timothy R. Lentz | Nurse Practitioner | 23 Wabanaki Way, Indian Island, ME 04468-1252 | 2006-11-28 |
| 1700950466 | Susan B. Judson-preble | Dental Hygienist | 23 Wabanaki Way, Indian Island, ME 04468-1252 | 2006-11-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770730012 | Karen Laflamme Davis | Speech-Language Pathologist | 270-a Main St, Old Town, ME 04468 | 2008-08-19 |
| 1104028281 | Susan C Hoovler | Licensed Practical Nurse | 242 Brunswick St., Penobscot Community Health Center, Old Town, ME 04468 | 2007-06-01 |
| 1326251000 | City of Old Town | Local Education Agency (LEA) | 156 Oak St., Old Town, ME 04468 | 2007-05-08 |
| 1891832382 | Nancy J. Mitchell Home Trust | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1 Sandy Beach Lane, Indian Island, ME 04468 | 2007-01-31 |
| 1639274913 | Dianne E Kallen | Family Medicine | 252 Brunswick St, Old Town, ME 04468 | 2006-09-13 |
| 1023510898 | Riversedge Chiropractic Wellness Center LLC | Clinic/Center | 227 Main St, Old Town, ME 04468 | 2018-03-07 |
| 1275906893 | Penobscot Community Health Center | Podiatrist | 242 Brunswick St, Old Town, ME 04468 | 2015-11-04 |
| 1740670421 | Kimberly Ann Yartklang | Nurse Practitioner | 242 Brunswick St, Old Town, ME 04468 | 2015-02-02 |
| 1134350077 | Kaliope C. Parousis | Pediatrics | 242 Brunswick Street, Old Town, ME 04468 | 2009-07-27 |
| 1720216245 | Christopher L. Johnston | Family Medicine | 242 Brunswick St, Old Town, ME 04468 | 2009-06-23 |
| Find all providers in zip 04468 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710404561 | Colasante Chiropractic, LLC | Clinic/Center | 184 Webster Street, #100, Lewiston, ME 04240 | 2017-08-23 |
| 1811365513 | Sarah D. Shepherd, D.o.llc | Clinic/Center | 27 Wadlin Road, Biddeford, ME 04005 | 2015-09-11 |
| 1215359146 | Rosebush Chiropractic LLC | Clinic/Center | 980 Forest Ave Ste 102, Portland, ME 04103-3357 | 2014-01-12 |
| 1609137843 | Access Health Renewal | Clinic/Center | 174 So. Freeport Road, Suite 2a, Freeport, ME 04032 | 2012-06-05 |
| 1225321961 | Orono Med Now | Clinic/Center | 16 Mill Street, Uite 4, Orono, ME 04473 | 2011-05-26 |
| 1003083346 | Gerald M Gerrish Dc Pa | Clinic/Center | 276 State Highway 3, Bar Harbor, ME 04609-7539 | 2008-05-15 |
| 1700050390 | Maine School Administrative District #75 | Clinic/Center | 73 Eagles Way, Mt. Ararat High School, Topsham, ME 04086-1239 | 2008-04-15 |
| 1710150966 | Berwick Walk In Care | Clinic/Center | 4 Dana Dr, Berwick, ME 03901-2767 | 2008-04-09 |
| 1285762328 | City of Calais | Clinic/Center | 34 Blue Devil Hill, Calais, ME 04619 | 2007-03-01 |
| 1942336722 | Lincoln Academy School Based Healthcenter | Clinic/Center | 81 Academy Hl, Newcastle, ME 04553-3433 | 2007-02-26 |
| Find all providers with the same taxonomy | ||||
| City | INDIAN ISLAND |
| Zip Code | 04468 |
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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.