Douglas Joseph Jorgensen, DO

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

ME 1550 Issued in ME

Practice address

29 Bowdoin St
Manchester, ME 04351-3554

Phone

(207) 622-4500

Fax

(207) 622-5452

NPI assigned

Jun 24, 2005

Last updated

Jan 22, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2015 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northern New England Primary Care

  dba Maine Recovery Center

  • Neuromusculoskeletal Medicine & OMM Physician
  • Manchester, ME
  • NPI 1730187923
  NPD Authorized official
• Manchester Interventional Spine, LLC

  • Medical Specialty Clinic/Center
  • Manchester, ME
  • NPI 1952671356
  Authorized official Same address or phone
• Northern New England Primary Care

  dba Manchester Family Health

  • Family Medicine Physician
  • Manchester, ME
  • NPI 1386949808
  Authorized official Same address or phone
• Northern New England Diagnostics

  dba Manchester Diagnostics

  • Clinical Medical Laboratory
  • Manchester, ME
  • NPI 1013205558
  NPD

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1043216922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 BOWDOIN ST",
            "city": "MANCHESTER",
            "state": "ME",
            "postal_code": "043513554",
            "telephone_number": "207-622-4500",
            "fax_number": "207-622-5452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 BOWDOIN ST",
            "city": "MANCHESTER",
            "state": "ME",
            "postal_code": "043513554",
            "telephone_number": "207-622-4500",
            "fax_number": "207-622-5452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORGENSEN",
        "first_name": "DOUGLAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "ME 1550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "041150",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO",
            "identifier": "HM197880",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott A Hayward, LCSW
• Shawn Kenneth Hodgdon
• Insight-Premier Health LLC (Diagnostic Imaging of Augusta)
• Angela Leigh Jarvis
• Anne Jenkins
• Wendy Brown Jorgensen, PAC
• Richard Ofoe Kavi
• Sara Keene, BCBA
• Kidspeace National Centers of New England Inc
• Kidspeace National Centers of New England Inc

• Neuromusculoskeletal Medicine & OMM Physician in Manchester, ME
• Providers in Manchester, ME by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.