Individual provider Active NPI

Shayna Lemke, DO

  • Family Medicine Physician
  • Bridgton, ME
National Provider Identifier
1104137058
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO2273 Issued in ME
Practice address
25 Hospital Dr
Bridgton, ME 04009-1167
Phone
(207) 647-2311
Fax
(207) 647-6015
NPI assigned
Jun 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO2273 ME Primary

Addresses

Primary practice location

25 Hospital Dr
Bridgton, ME 04009-1167

Mailing address

25 Hospital Dr
Bridgton, ME 04009-1167
Phone (207) 647-2311

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190109000262 WA Practitioner - Family Practice 4082861794 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 W Sims Way
Suite C
Port Townsend, WA 98368-3031
Phone (360) 385-6297

834 Sheridan St
Port Townsend, WA 98368-2443
Phone (360) 385-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Public Hospital District No 2 CurrentSince Oct 1, 2018 Accepting new patients
Jefferson County Public Hospital District No 2 CurrentSince Oct 1, 2018 Accepting new patients

Locations

834 Sheridan St
Port Townsend, WA 98368
Phone (360) 344-0400

1200 W Sims Way
Ste C
Port Townsend, WA 98368
Phone (360) 385-6297

Organizations & group practices 2

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": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1104137058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 HOSPITAL DR",
            "city": "BRIDGTON",
            "state": "ME",
            "postal_code": "040091167",
            "telephone_number": "207-647-2311",
            "fax_number": "207-647-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 HOSPITAL DR",
            "city": "BRIDGTON",
            "state": "ME",
            "postal_code": "040091167",
            "telephone_number": "207-647-2311",
            "fax_number": "207-647-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMKE",
        "first_name": "SHAYNA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO2273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgton, ME

Sources for this page

Verify at the official NPI Registry.