Todd H Chisholm, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1230 Issued in ME

Practice address

12 Union St
Rockland, ME 04841-2739

Phone

(207) 701-4400

Fax

(207) 701-4487

NPI assigned

Oct 12, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Northern Maine Medical Center

  • Critical Access Hospital
  • Fort Kent, ME
  • NPI 1568465144
  Medicare reassignment NPD
• State of Maine

  dba Dorothea Dix Psychiatric Center

  • Psychiatric Hospital
  • Bangor, ME
  • NPI 1699776146
  Medicare reassignment NPD
• Northern Maine Medical Center

  dba St John Valley Pharmacy

  • Community/Retail Pharmacy
  • Fort Kent, ME
  • NPI 1952303422
  NPD
• State of Maine

  dba Riverview Psychiatric Hospital

  • Psychiatric Hospital
  • Augusta, ME
  • NPI 1053319566
  NPD
• Copper Country Community Mental Health Services Board

  • Community/Behavioral Health Agency
  • Ontonagon, MI
  • NPI 1780871137
  NPD

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1093804577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 UNION ST",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412739",
            "telephone_number": "207-701-4400",
            "fax_number": "207-701-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 UNION ST",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412739",
            "telephone_number": "207-701-4400",
            "fax_number": "207-701-4487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 East Main Street",
            "address_purpose": "LOCATION",
            "city": "Fort Kent",
            "state": "ME",
            "postal_code": "04743",
            "country_code": "US",
            "telephone_number": "207-834-3101",
            "fax_number": "207-834-2917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "TODD",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cedar Street Preschool Inc
• Rosetta Celentano
• Gary Chapin, M.S.
• Justine Charbonneau, LCSW
• Child Development Services
• Nicholas James Citriglia, LCPC, LADC
• City of Rockland (Rockland Fire & EMS)
• Nicole Pearl Clarke, LMFT, LADC, LPN
• Kathryn L Clement, LCSW
• Elizabeth Cleverly, LCSW

• Physician Assistant in Rockland, ME
• Providers in Rockland, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.