NPIMap

Organization Active NPI

Gorham Crossing Primary Care

  • Primary Care Clinic/Center
  • Gorham, ME
National Provider Identifier
1013383777
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
CNP151056 Issued in ME
Legal business name
GORHAM CROSSING PRIMARY CARE
Practice address
19 S Gorham Xing
Gorham, ME 04038-2690
Phone
(207) 839-9101
Fax
(207) 839-9201
NPI assigned
Aug 18, 2015
Organization subpart
Yes
Parent organization
MERCY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Authorized official

Name
Dr. Michael Duffy, M.D.
Title
Medical Director
Phone
(207) 839-9101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X CNP151056 ME Primary

Addresses

Primary practice location

19 S Gorham Xing
Gorham, ME 04038-2690

Mailing address

19 S Gorham Xing
Gorham, ME 04038-2690
Phone (207) 839-9101

National Provider Directory

National Provider Directory
Tax ID family
Mercy Hospital7 organizations share this tax ID, including this one
Part of
Mercy Hospital

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

19 S Gorham Xing
Gorham, ME 04038
Phone (207) 535-1400

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1013383777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 S GORHAM XING",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040382690",
            "telephone_number": "207-839-9101",
            "fax_number": "207-839-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 S GORHAM XING",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040382690",
            "telephone_number": "207-839-9101",
            "fax_number": "207-839-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORHAM CROSSING PRIMARY CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HOSPITAL",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "DUFFY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "207-839-9101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "ME",
            "license": "CNP151056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gorham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.