Bernadette Mubang, REGISTERED NURSE

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Practice address

52 North St
Machias, ME 04654-1137

Phone

(207) 255-4006

NPI assigned

Jan 21, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Neighborhood Residential, Inc

  • Developmental Disabilities Clinic/Center
  • Washington, DC
  • NPI 1417602475
  NPD

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1023760964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 NORTH ST",
            "city": "MACHIAS",
            "state": "ME",
            "postal_code": "046541137",
            "telephone_number": "207-255-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 NORTH ST",
            "city": "MACHIAS",
            "state": "ME",
            "postal_code": "046541137",
            "telephone_number": "207-255-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUBANG",
        "first_name": "BERNADETTE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan T Merrill, APRN, FNP-BC
• Patricia Ann Merritt, R.N. B.S.N
• Jill Mertinke, LCPC
• Sherrie Ann Metcalf, BHP
• Avanelle Mitchell
• Bjarni L Myers, CNM, MS
• Gretchen A Neubelt, MHRT-C
• Northfield School Department
• Jordyn Lynn Olsson, OTR/L
• Jessica C. Oram, MHRT-CSP

• Developmental Disabilities Clinic/Center in Machias, ME
• Providers in Machias, ME by specialty
• Developmental Disabilities Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.