Cardiovascular Consultants of Maine PA

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

CARDIOVASCULAR CONSULTANTS OF MAINE PA

Practice address

96 Campus Dr Ste 1
Scarborough, ME 04074-7133

Phone

(207) 885-9905

NPI assigned

Jul 4, 2006

Last updated

Sep 23, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William A Dietz, M.D.

Title

President

Phone

(207) 885-9905

Specialties & licenses 4

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Patricia Ann Keohan, NP

  • Nurse Practitioner
  • Augusta, ME
  • NPI 1023129723
  NPD (past)
• Wayne A Kruithoff, M.D.

  • Cardiovascular Disease Physician
  • Portland, ME
  • NPI 1447220561
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1114957388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 CAMPUS DR STE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747133",
            "telephone_number": "207-885-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 CAMPUS DR STE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747133",
            "telephone_number": "207-885-9905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR CONSULTANTS OF MAINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "DIETZ",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-885-9905",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ME",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "ME",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "ME",
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "ME",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109260000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alison E Cameron, N.P.
• Camp Ketcha
• Andrew J Candelore, DO
• Philip Capriotti
• Ryan A Card, PA-C
• Holly Helena Carletti Alivizatos, LCPC
• Robert A Carlson, MD
• Mary-Elizabeth Carolan, LMT, EMT-P
• Matthew Luke Caron, PHARM.D.
• Charles M Carpenter, MD

• Cardiovascular Disease Physician in Scarborough, ME
• Providers in Scarborough, ME by specialty
• Cardiovascular Disease Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.