NPIMap

Organization Active NPI

Jonathan Shill MD

  • Family Medicine Physician
  • Kennebunk, ME
National Provider Identifier
1043615453
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JONATHAN SHILL MD
Practice address
26 Barnard LN
Kennebunk, ME 04043-6714
Phone
(207) 502-7074
Fax
(207) 502-7079
NPI assigned
Oct 28, 2014
Last updated
Oct 28, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
JONATHAN SHILL MD PHD LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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

Authorized official

Name
Jonathan Shill, MDNPI 1548295900
Title
Owner/Provider
Phone
(207) 502-7074

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

26 Barnard LN
Kennebunk, ME 04043-6714

Mailing address

26 Barnard LN
Kennebunk, ME 04043-6714
Phone (207) 502-7074

National Provider Directory

National Provider Directory
Part of
Jonathan Shill MD

Practitioners & affiliated clinicians

Practitioners 9

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": "1414454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1043615453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 BARNARD LN",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436714",
            "telephone_number": "207-502-7074",
            "fax_number": "207-502-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 BARNARD LN",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436714",
            "telephone_number": "207-502-7074",
            "fax_number": "207-502-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN SHILL MD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JONATHAN SHILL MD PHD LLC",
        "enumeration_date": "2014-10-28",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "SHILL",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "207-502-7074",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennebunk, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.