Individual provider Active NPI

Jonathan Paul Bedard, DSP, CRMA, CPR

  • Community Health Worker
  • Biddeford, ME
National Provider Identifier
1093468829
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
27 Quimby St Apt 102
Biddeford, ME 04005-5226
Phone
(207) 229-8959
NPI assigned
Feb 1, 2022
Last updated
Feb 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X ME Primary

Addresses

Primary practice location

27 Quimby St Apt 102
Biddeford, ME 04005-5226

Mailing address

27 Quimby St Apt 102
Biddeford, ME 04005-5226
Phone (207) 229-8959

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1093468829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 QUIMBY ST APT 102",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040055226",
            "telephone_number": "207-229-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 QUIMBY ST APT 102",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040055226",
            "telephone_number": "207-229-8959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDARD",
        "first_name": "JONATHAN",
        "middle_name": "PAUL",
        "credential": "DSP, CRMA, CPR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "ME",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biddeford, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.