Individual provider Active NPI

Kathleen A Norris, DC

  • Chiropractor
  • Portland, ME
National Provider Identifier
1114912664
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
697 Issued in ME
Practice address
449 Forest Ave
2ND Floor
Portland, ME 04101-2029
Phone
(207) 772-6411
Fax
(207) 772-6411
NPI assigned
Sep 12, 2005
Last updated
Feb 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 697 ME Primary

Addresses

Primary practice location

449 Forest Ave
2ND Floor
Portland, ME 04101-2029

Mailing address

449 Forest Ave
2ND Floor
Portland, ME 04101-2029
Phone (207) 772-6411

Other identifiers 3

IdentifierTypeStateIssuer
1222800000MedicaidME
INT042OtherHARVARD PILGRIM
005242OtherANTHEM BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050523000285 ME Practitioner - Chiropractic 7618918400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

449 Forest Ave
Suite 206
Portland, ME 04101-2042
Phone (207) 772-6411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
697MEMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Chiropractic Limited Liability Company Chiropractor CurrentSince Jan 1, 2010 Accepting new patients

Locations

449 Forest Ave
Ste 2
Portland, ME 04101
Phone (207) 761-1741

449 Forest Ave
Ste 206
Portland, ME 04101
Phone (207) 772-6411

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1114912664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 FOREST AVE",
            "address_2": "2ND FLOOR",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012029",
            "telephone_number": "207-772-6411",
            "fax_number": "207-772-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 FOREST AVE",
            "address_2": "2ND FLOOR",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012029",
            "telephone_number": "207-772-6411",
            "fax_number": "207-772-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1222800000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "INT042",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "005242",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.