Active NPI
Kimberly Christine Drouin, PH.D.
- Psychologist
- South Portland, ME
National Provider Identifier
1063563161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS1191
- Practice address
- 609 Main St
Suite 3
South Portland, ME 04106-5453 - Phone
- (207) 775-2220
- Fax
- (207) 775-2226
- NPI assigned
- Jan 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 8121 | MA | |
| Psychologist | 103T00000X | PS1191 | ME | Primary |
Addresses
Primary practice location
609 Main St
Suite 3
South Portland, ME 04106-5453
Mailing address
609 Main St
Suite 3
South Portland, ME 04106-5453
Phone (207) 775-2220
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0006065 | Other | ME | MEDICARE PTAN |
| 472796000 | Other | MA | MAGELLAN |
| W06272 | Other | MA | BCBS OF MASS. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224720000000",
"number": "1063563161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 MAIN ST",
"address_2": "SUITE 3",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041065453",
"telephone_number": "207-775-2220",
"fax_number": "207-775-2226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 MAIN ST",
"address_2": "SUITE 3",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041065453",
"telephone_number": "207-775-2220",
"fax_number": "207-775-2226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DROUIN",
"first_name": "KIMBERLY",
"middle_name": "CHRISTINE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2008-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "8121",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "ME",
"license": "PS1191",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "0006065",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "472796000",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MASS.",
"identifier": "W06272",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.