Active NPI
Richard Raymond, DMD
- Dentist
- Fort Kent, ME
National Provider Identifier
1023024585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2406
- Practice address
- 139 Market Street
Suite 107
Fort Kent, ME 04743 - Phone
- (207) 834-3907
- Fax
- (207) 834-3908
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2406 | ME | Primary |
Addresses
Primary practice location
139 Market Street
Suite 107
Fort Kent, ME 04743
Mailing address
P.O. Box 290
139 Market Street Suite 107
Fort Kent, ME 04743
Phone (207) 834-3907
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125000000 | Medicaid | ME | |
| 037354 | Other | ME | BLUE CROSS BLUE SHEILD |
| 1250000000 | Medicaid | ME | |
| R0806 | Other | ME | BLUE CROSS FEDERAL |
| 000-610591 | Other | UNITED CONCORDIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2406 | ME | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272412800000",
"number": "1023024585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 290",
"address_2": "139 MARKET STREET SUITE 107",
"city": "FORT KENT",
"state": "ME",
"postal_code": "04743",
"telephone_number": "207-834-3907",
"fax_number": "207-834-3908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 MARKET STREET",
"address_2": "SUITE 107",
"city": "FORT KENT",
"state": "ME",
"postal_code": "04743",
"telephone_number": "207-834-3907",
"fax_number": "207-834-3908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAYMOND",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2010-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ME",
"license": "2406",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "125000000",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD",
"identifier": "037354",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1250000000",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS FEDERAL",
"identifier": "R0806",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "000-610591",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Kent, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.