NPIMap

Organization Active NPI

Regional Medical Center at Lubec

  • Federally Qualified Health Center (FQHC)
  • East Machias, ME
National Provider Identifier
1104967884
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
CO1949 Issued in ME
Legal business name
REGIONAL MEDICAL CENTER AT LUBEC
Practice address
893 Main St
East Machias, ME 04630-4051
Phone
(207) 255-0102
Fax
(207) 255-4645
NPI assigned
Feb 8, 2007
Last updated
Jun 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Authorized official

Name
Marilyn F Hughes
Title
Ceo
Phone
(207) 733-1090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X CO1949 ME Primary

Addresses

Primary practice location

893 Main St
East Machias, ME 04630-4051

Mailing address

893 Main St
East Machias, ME 04630-4051
Phone (207) 255-0102

Other identifiers 2

IdentifierTypeStateIssuer
167910100MedicaidME
4618290001OtherMEMEDICARE DME

Other names 1

  • HealthWays Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040812001504 ME Part B Supplier - Clinic/Group Practice 8224949888 Receives reassigned benefits from 10 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: East Machias, ME; Lubec, ME
O20061115000257 ME Part A Provider - Federally Qualified Health Center (FQHC) 8224949888 Practice locations: East Machias, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104967884. Details of each certification follow.

Federally qualified health center certification: CCN 201862

Legal name
REGIONAL MEDICAL CENTER AT LUBEC INC
Doing business as
HEALTHWAYS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 14, 2006
Last certification
Dec 14, 2006
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1971 in ME
Enrollment address
893 Main St
East Machias, ME 46304051

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Regional Medical Center at Lubec5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

893 Main St
East Machias, ME 04630
Phone (207) 255-0102

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Roger Quirk Individual Corporate OfficerBoard Chair Apr 1, 2009
James Doherty Individual Corporate OfficerVice Chair Apr 1, 2011
Joanne Case Individual Corporate DirectorBoard Member Apr 1, 2021
Marilyn Hughes Individual Corporate OfficerCeo Nov 17, 2008
Operational/Managerial ControlCeo Nov 17, 2008
Julia Brady Individual Corporate DirectorBoard Member Apr 1, 2015
Jerry Grubel Individual Corporate DirectorBoard Member Apr 1, 2018
Marcia Jackson Individual Corporate DirectorBoard Member Apr 1, 2017
Anne C Perry Individual Corporate DirectorBoard Member Apr 1, 2018
Sara McConnell Individual Corporate OfficerBoard Secretary Apr 1, 2016
Elizabeth Kelly Individual W-2 Managing EmployeeReimbursement Supervisor Jan 14, 2020

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1104967884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "893 MAIN ST",
            "city": "EAST MACHIAS",
            "state": "ME",
            "postal_code": "046304051",
            "telephone_number": "207-255-0102",
            "fax_number": "207-255-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "893 MAIN ST",
            "city": "EAST MACHIAS",
            "state": "ME",
            "postal_code": "046304051",
            "telephone_number": "207-255-0102",
            "fax_number": "207-255-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL MEDICAL CENTER AT LUBEC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-733-1090"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "ME",
            "license": "CO1949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167910100",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "4618290001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthWays",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "HealthWays",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in East Machias, ME

Sources for this page

Verify at the official NPI Registry.