Individual provider Active NPI

Maegan L Woodman, FNPC

  • Nurse Practitioner
  • Bangor, ME
National Provider Identifier
1013404789
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP181137 Issued in ME
Practice address
6 Telcom Dr FL 2
Bangor, ME 04401-3072
Phone
(207) 947-0147
Fax
(207) 990-3365
NPI assigned
Apr 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP181137 ME Primary

Addresses

Primary practice location

6 Telcom Dr FL 2
Bangor, ME 04401-3072

Mailing address

PO Box 1599
Bangor, ME 04402-1599
Phone (207) 404-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180807002223 ME Practitioner - Nurse Practitioner 4688922610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penobscot Community Health CenterGroup PAC ID 0143212670, 135 clinicians

Practice addresses (Care Compare)

242 Brunswick St
Old Town, ME 04468-1613
Phone (207) 827-6128

Hospital & facility affiliations

  • St Joseph Hospital Hospital, Bangor, ME, CCN 200001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP181137MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Penobscot Community Health Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1013404789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-404-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TELCOM DR FL 2",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013072",
            "telephone_number": "207-947-0147",
            "fax_number": "207-990-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODMAN",
        "first_name": "MAEGAN",
        "middle_name": "L",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-18",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP181137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.