Individual provider Active NPI

Amy A Langley, FNPC

  • Nurse Practitioner
  • Brewer, ME
National Provider Identifier
1083906622
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP111031 Issued in ME
Practice address
735 Wilson Street
Brewer, ME 04412-1003
Phone
(207) 992-2601
Fax
(207) 989-2280
NPI assigned
May 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP111031 ME Primary

Addresses

Primary practice location

735 Wilson Street
Brewer, ME 04412-1003

Mailing address

PO Box 1599
Bangor, ME 04402-1599
Phone (207) 945-5247

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
I20110901000587 ME Practitioner - Nurse Practitioner 3971773888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penobscot Community Health CenterGroup PAC ID 0143212670, 135 clinicians

Practice addresses (Care Compare)

1012 Union St
Bangor, ME 04401-3058

1068 Union St
Bangor, ME 04401-3016
Phone (207) 404-8181

242 Brunswick St
Old Town, ME 04468-1613
Phone (207) 827-6128

735 Wilson St
Brewer, ME 04412-1000
Phone (207) 989-1567

992 Union St
Bangor, ME 04401-3057

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP111031MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Penobscot Community Health Center CurrentSince Jul 11, 2011 Accepting new patients
Penobscot Community Health Center CurrentSince Jul 11, 2011 Accepting new patients
Penobscot Community Health Center Current Accepting new patients
Penobscot Community Health Center Past Accepting new patients

Locations

1012 Union St
Ste 3
Bangor, ME 04401
Phone (207) 404-8040

1012 Union St
Ste 1
Bangor, ME 04401
Phone 2079455247407

1012 Union St
Bangor, ME 04401
Phone (207) 404-8200

735 Wilson St
Brewer, ME 04412
Phone (207) 989-1567

Organizations & group practices 4

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 3

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": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1083906622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-945-5247",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 WILSON STREET",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121003",
            "telephone_number": "207-992-2601",
            "fax_number": "207-989-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGLEY",
        "first_name": "AMY",
        "middle_name": "A",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP111031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewer, ME

Sources for this page

Verify at the official NPI Registry.