Center for Integrative and Regenerative Medicine

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CENTER FOR INTEGRATIVE AND REGENERATIVE MEDICINE

Practice address

277 State St Ste 1B
Bangor, ME 04401-5440

Phone

(207) 947-9200

NPI assigned

Jul 10, 2020

Organization subpart

No

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

Authorized official

Name

Jacqueline Tardif

Title

Office Manager

Phone

(207) 947-9200

Specialties & licenses 1

Addresses

Other names 1

• Center for Integrative and Regenerative Medicine Other name

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598832000000",
    "number": "1003434655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 STATE ST STE 1B",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 STATE ST STE 1B",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015440",
            "telephone_number": "207-947-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INTEGRATIVE AND REGENERATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-28",
        "status": "A",
        "authorized_official_last_name": "TARDIF",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "207-947-9200"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Integrative and Regenerative Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Center for Integrative and Regenerative Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Center for Integrative and Regenerative Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christine Elizabeth Cattan, RPH
• Robert Wayne Cattan Jr., R.PH
• Christina Marie Caver, LCSW
• Elisabeth Grace Cawley, PA-C
• CCM-4U, LLC
• Centerwell Certified Healthcare Corp.
• Anne Elizabeth Chamberlain Small
• Nicholas Matthew Chamberlain-Nunes, RDH
• Michelle Chamberland, PMH-NP
• Avian Chien Leong Vincent Chang, M.D.

• All providers in Bangor, ME
• Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.