Individual provider Active NPI

Kelly Lemieux Dudley, NP-C

  • Primary Care Nurse Practitioner
  • Augusta, ME
National Provider Identifier
1053781492
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
CNP151078 Issued in ME
Practice address
250 Arsenal St
Augusta, ME 04330-5742
Phone
(207) 624-3967
NPI assigned
Sep 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X CNP151078 ME Primary

Addresses

Primary practice location

250 Arsenal St
Augusta, ME 04330-5742

Mailing address

250 Arsenal St
Augusta, ME 04330-5742
Phone (207) 624-3967

Other names 1

  • Kelly-Lynn Lemieux Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171124000164 ME Practitioner - Nurse Practitioner 7214294404 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

149 N St
Waterville, ME 04901
Phone (207) 872-1000

35 Medical Ctr Pkwy
Augusta, ME 04330-8160
Phone (207) 621-1000

Hospital & facility affiliations

  • Maine General Medical Center Hospital, Augusta, ME, CCN 200039
  • Mainehealth Franklin Hospital Hospital, Farmington, ME, CCN 201316
  • Mainehealth Waldo Hospital Hospital, Belfast, ME, CCN 201312

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
75.39
Promoting interoperability
84
Improvement activities
40
Cost
75.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Sep 30, 2017 Accepting new patients
Mainegeneral Medical Center CurrentSince Sep 30, 2017 Accepting new patients
State of Maine Past Accepting new patients

Locations

10 Water St
Ste 202
Waterville, ME 04901
Phone (207) 873-9846

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Interoperability endpoints

  • Direct secure messaging: kellydudley@mgh.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443398400000",
    "number": "1053781492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 ARSENAL ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305742",
            "telephone_number": "207-624-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 ARSENAL ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305742",
            "telephone_number": "207-624-3967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "KELLY",
        "middle_name": "LEMIEUX",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-28",
        "last_updated": "2015-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "ME",
            "license": "CNP151078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY-LYNN",
            "last_name": "LEMIEUX",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Augusta, ME

Sources for this page

Verify at the official NPI Registry.