NPIMap

Individual provider Active NPI

Owen Vanderpool Davis, FNP-C

  • Family Nurse Practitioner
  • Scarborough, ME
National Provider Identifier
1083361026
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP211303 Issued in ME
Practice address
92 Campus Dr Ste a
Scarborough, ME 04074-7133
Phone
(207) 885-0011
NPI assigned
Mar 9, 2022
Last updated
Mar 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP211303 ME Primary

Addresses

Primary practice location

92 Campus Dr Ste a
Scarborough, ME 04074-7133

Mailing address

91B Burnell Dr
Yarmouth, ME 04096-7703
Phone (207) 450-6377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220405002297 ME Practitioner - Nurse Practitioner 2264828938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

92 Campus Dr
Scarborough, ME 04074-7229

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jul 1, 2023 Accepting new patients
Maine Medical Partners CurrentSince May 16, 2022 Accepting new patients
Maine Medical Partners CurrentSince May 16, 2022 Accepting new patients
Mainehealth CurrentSince Jul 1, 2023 Accepting new patients
Mainehealth Current Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

92 Campus Dr
Fl 1
Scarborough, ME 04074
Phone (207) 885-0011

92 Campus Dr
Ste A
Scarborough, ME 04074
Phone (207) 885-0011

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

Interoperability endpoints

  • Direct secure messaging: odavis72326@direct.mmc.mainehealth.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1083361026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91B BURNELL DR",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040967703",
            "telephone_number": "207-450-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 CAMPUS DR STE A",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747133",
            "telephone_number": "207-885-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "OWEN",
        "middle_name": "VANDERPOOL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-09",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP211303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.