NPIMap

Organization Active NPI

Mid-Maine Internal Medicine

  • Internal Medicine Physician
  • North Vassalboro, ME
National Provider Identifier
1043224330
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MID-MAINE INTERNAL MEDICINE
Practice address
905 Main Street
North Vassalboro, ME 04962
Phone
(207) 873-6173
Fax
(207) 873-4514
NPI assigned
Jul 29, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
John E Burke, MDNPI 1588620330
Title
President
Phone
(207) 873-6173

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

905 Main Street
North Vassalboro, ME 04962

Mailing address

PO Box 247
N Vassalboro, ME 04962-0247
Phone (207) 873-6173

Other identifiers 1

IdentifierTypeStateIssuer
C20487OtherRAILROAD MEDICARE

Other names 1

  • BURKE,SMITH & PRESTON, MD,PA Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1043224330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 247",
            "city": "N VASSALBORO",
            "state": "ME",
            "postal_code": "049620247",
            "telephone_number": "207-873-6173",
            "fax_number": "207-873-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 MAIN STREET",
            "city": "NORTH VASSALBORO",
            "state": "ME",
            "postal_code": "04962",
            "telephone_number": "207-873-6173",
            "fax_number": "207-873-4514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-MAINE INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-873-6173",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "C20487",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BURKE,SMITH & PRESTON, MD,PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.