Pat Chanterelle LLC

Primary specialty

Special HospitalTaxonomy code 284300000X

License

CR601 Issued in ME

Legal business name

PAT CHANTERELLE LLC

Practice address

30 Forest Falls Dr
Suite 1
Yarmouth, ME 04096-6983

Phone

(207) 846-7711

Fax

(207) 846-7711

NPI assigned

Apr 17, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Patricia Chanterelle, D.C.

Title

President

Phone

(207) 846-7711

Specialties & licenses 1

Addresses

Other names 1

• Patricia Chanterelle, D.C. Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Catherine Ann Jakubowitch, M.D.

  • Psychiatry Physician
  • Portland, ME
  • NPI 1891804415
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341878400000",
    "number": "1003173972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 FOREST FALLS DR",
            "address_2": "SUITE 1",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966983",
            "telephone_number": "207-846-7711",
            "fax_number": "207-846-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 FOREST FALLS DR",
            "address_2": "SUITE 1",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966983",
            "telephone_number": "207-846-7711",
            "fax_number": "207-846-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAT CHANTERELLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-17",
        "last_updated": "2012-07-10",
        "status": "A",
        "authorized_official_last_name": "CHANTERELLE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-846-7711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "ME",
            "license": "CR601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patricia Chanterelle, D.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Maisie Labrie Ostrye, REGISTERED DIETITIAN
• Joshua Palomera, MS, RD, LDN, CSN
• Shashi T. Panozzo, MD
• Kathi J Paradise, M.S.,OTR/L
• Heather Danielle Parlin, LCPC
• Jeffrey S. Patch, MD
• Patricia J. Phillips, DO, PA
• Patronus LLC
• Kevin Paulin
• Peaceful Me, PLLC

• Special Hospital in Yarmouth, ME
• Providers in Yarmouth, ME by specialty
• Special Hospital in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.