Individual provider Active NPI

Kathleen S. Brown, ANP

  • Family Nurse Practitioner
  • Portland, ME
National Provider Identifier
1114020179
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
041441 Issued in ME
Practice address
84 Marginal Way
Portland, ME 04101
Phone
(207) 774-5816
Fax
(207) 523-8595
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 041441 ME Primary

Addresses

Primary practice location

84 Marginal Way
Portland, ME 04101

Mailing address

100 Gannett Dr Ste C
South Portland, ME 04106-5900
Phone (207) 347-2947

Other identifiers 1

IdentifierTypeStateIssuer
NP305502OtherMEMEDICARE PTAN

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050701000123 ME Practitioner - Nurse Practitioner 3173569944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermed PAGroup PAC ID 5092605261, 185 clinicians

Practice addresses (Care Compare)

100 Foden Rd
South Portland, ME 04106-2327
Phone (207) 874-1489

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intermed, PA CurrentSince Dec 29, 2009 Accepting new patients
Intermed, PA CurrentSince Dec 29, 2009 Accepting new patients

Locations

84 Marginal Way
Portland, ME 04101
Phone (207) 774-5816

100 Foden Rd
Ste W-203
South Portland, ME 04106
Phone (207) 523-3900

100 Gannett Dr
Ste C
South Portland, ME 04106
Phone (207) 523-3649

100 Foden Rd
South Portland, ME 04106
Phone (207) 828-1122

100 Foden Rd
Ste W-100
South Portland, ME 04106
Phone (207) 523-3900

100 Foden Rd
Ste 100
South Portland, ME 04106
Phone (207) 874-1489

Interoperability endpoints

  • Direct secure messaging: kathleen.brown@int.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1114020179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GANNETT DR STE C",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065900",
            "telephone_number": "207-347-2947",
            "fax_number": "207-874-2317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 MARGINAL WAY",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04101",
            "telephone_number": "207-774-5816",
            "fax_number": "207-523-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KATHLEEN",
        "middle_name": "S.",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "041441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NP305502",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.