NPIMap

Organization Active NPI

Sebasticook Valley Health

Doing business as Northern Light Primary Care - Pittsfield

  • Rural Health Clinic/Center
  • Pittsfield, ME
National Provider Identifier
1063617744
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SEBASTICOOK VALLEY HEALTH
Doing business as
Northern Light Primary Care - Pittsfield
SVH Family Care
Practice address
470 Somerset Ave
Pittsfield, ME 04967-4928
Phone
(207) 487-3884
NPI assigned
Jun 20, 2007
Last updated
Oct 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Authorized official

Name
Randall Clark
Title
President
Phone
(207) 487-4022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X ME Primary

Addresses

Primary practice location

470 Somerset Ave
Pittsfield, ME 04967-4928

Mailing address

447 N Main St
Pittsfield, ME 04967-3707
Phone (207) 487-5141

Other names 2

  • Northern Light Primary Care - Pittsfield Doing business as
  • SVH Family Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070626000284 ME Part A Provider - Rural Health Clinic 3476462797 Practice locations: Pittsfield, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063617744. Details of each certification follow.

Rural health clinic certification: CCN 208514

Legal name
SEBASTICOOK VALLEY HEALTH
Doing business as
NORTHERN LIGHT HEALTH CENTER PITTSFIELD
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 30, 2007
Last certification
Mar 10, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Mar 4, 1963 in ME
Enrollment address
470 Somerset Ave
Pittsfield, ME 04967-4928

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0090460Northern Light Health Center470 Somerset Avenue, Pittsfield, ME 04967Certificate of waiverJan 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Steven J Badeen MD5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

489 State St
#2
Bangor, ME 04401
Phone (207) 973-4519

1309 Main St
Clinton, ME 04927
Phone (207) 426-0976

26 Main St
Ste 2
Newport, ME 04953
Phone (207) 368-5747

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stacey Fitts Individual Corporate DirectorBoard Member Oct 1, 2018
Emily B Cianchette Individual Corporate DirectorBoard Member Oct 1, 2023
Alicia Nichols Individual Corporate DirectorBoard Member Oct 1, 2018
Jon Christensen Individual Corporate DirectorBoard Member Apr 25, 2022
Jeremy West Individual Corporate DirectorBoard Member Apr 27, 2020
Timothy J Dentry Individual Corporate OfficerPresident & Ceo of Emhs Apr 1, 2020
Operational/Managerial ControlPresident & Ceo of Emhs Apr 1, 2020
Kady Huff Individual Corporate DirectorBoard Member Jun 26, 2023
Brett Danforth Individual Corporate DirectorBoard Member Nov 27, 2023
Eastern Maine Healthcare Services Organization, Brewer, ME Non-profit Operational/Managerial Control Mar 23, 2015 100%
Linda Woolley Individual Corporate DirectorBoard Member Oct 1, 2018
Charles Cianchette Individual Corporate DirectorBoard Member Oct 1, 2018
Robin Chase Individual Corporate DirectorBoard Member Apr 22, 2019
Sandra Delano Individual Corporate DirectorBoard Member Apr 25, 2022
Randall L. Clark Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2022
Corporate Officer Apr 1, 2022
Operational/Managerial Control Apr 1, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 15

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 15

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1063617744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 N MAIN ST",
            "city": "PITTSFIELD",
            "state": "ME",
            "postal_code": "049673707",
            "telephone_number": "207-487-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 SOMERSET AVE",
            "city": "PITTSFIELD",
            "state": "ME",
            "postal_code": "049674928",
            "telephone_number": "207-487-3884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEBASTICOOK VALLEY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-487-4022"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "ME",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Light Primary Care - Pittsfield",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SVH Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pittsfield, ME

Sources for this page

Verify at the official NPI Registry.