NPIMap

Organization Active NPI

Charles a Dean Memorial Hospital

Doing business as Northern Light CA Dean Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Greenville, ME
National Provider Identifier
1104834977
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
36400 Issued in ME
Legal business name
CHARLES A DEAN MEMORIAL HOSPITAL
Doing business as
Northern Light CA Dean Hospital
Practice address
364 Pritham Avenue
Greenville, ME 04441
Phone
(207) 695-5200
NPI assigned
Aug 4, 2006
Last updated
Sep 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Authorized official

Name
Jennifer Marie Goodrich
Title
VP of Finance
Phone
(207) 695-5209

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 36400 ME Primary

Addresses

Primary practice location

364 Pritham Avenue
Greenville, ME 04441

Mailing address

364 Pritham Ave
Greenville, ME 04441-7214
Phone (207) 695-5200

Other names 1

  • Northern Light CA Dean Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210913001625 ME Part A Provider - Critical Access Hospital 1557279031 Practice locations: Greenville, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104834977. Details of each certification follow.

Hospital certification: CCN 20Z301

Legal name
CHARLES A DEAN MEMORIAL HOSPITAL
Doing business as
CHARLES A DEAN MEMORIAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1939 in ME
Enrollment address
364 Pritham Ave
Greenville, ME 44417214
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

22 Haley Ct
Sangerville, ME 04479
Phone (207) 695-5200

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
David Richards Individual Corporate Director Jan 9, 2000
Diane Bartley Individual Corporate Director Jan 8, 2001
Darin M Peck Individual Corporate Director Sep 4, 2003
Eastern Maine Healthcare Services Organization, Brewer, ME Non-profit 5% Or Greater Direct Ownership Interest Jul 31, 1998 100%
Faye Booker Individual Corporate Director Jan 9, 2000
Eugene Murray Individual W-2 Managing Employee Oct 6, 2002
Sharon Hastings Individual Corporate Director Jan 8, 2005
Gregg M Christensen Individual Corporate Director Jan 3, 2014

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 15

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 15

Practitioners & affiliated clinicians

Practitioners 116

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 116

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790640000000",
    "number": "1104834977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 PRITHAM AVE",
            "city": "GREENVILLE",
            "state": "ME",
            "postal_code": "044417214",
            "telephone_number": "207-695-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 PRITHAM AVENUE",
            "city": "GREENVILLE",
            "state": "ME",
            "postal_code": "04441",
            "telephone_number": "207-695-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES A DEAN MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A",
        "authorized_official_last_name": "GOODRICH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "207-695-5209"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "ME",
            "license": "36400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Light CA Dean Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, ME

Sources for this page

Verify at the official NPI Registry.