NPIMap

Organization Active NPI

Northern Maine General

Doing business as Mercy Home

  • Skilled Nursing Facility
  • Eagle Lake, ME
National Provider Identifier
1124090238
Registry record updated Mar 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1999 Issued in ME
Legal business name
NORTHERN MAINE GENERAL
Doing business as
Mercy Home
Practice address
3402 Arroostook Rd
Eagle Lake, ME 04739-0310
Phone
(207) 444-5152
NPI assigned
Feb 2, 2006
Last updated
Mar 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2012

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

Authorized official

Name
Reynold Raymond
Title
Chief Executive Officer
Phone
(207) 444-5152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1999 ME Primary

Addresses

Primary practice location

3402 Arroostook Rd
Eagle Lake, ME 04739-0310

Mailing address

PO Box 310
Eagle Lake, ME 04739-0310
Phone (207) 444-5152

Other identifiers 1

IdentifierTypeStateIssuer
102850000MedicaidME

Other names 1

  • Mercy Home Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

21 Aldrich Dr
Caribou, ME 04736
Phone (207) 492-1036

Practitioners & affiliated clinicians

Practitioners 6

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": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333065600000",
    "number": "1124090238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310",
            "city": "EAGLE LAKE",
            "state": "ME",
            "postal_code": "047390310",
            "telephone_number": "207-444-5152",
            "fax_number": "207-444-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3402 ARROOSTOOK RD",
            "city": "EAGLE LAKE",
            "state": "ME",
            "postal_code": "047390310",
            "telephone_number": "207-444-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MAINE GENERAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2012-03-30",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "REYNOLD",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "207-444-5152"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ME",
            "license": "1999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102850000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle Lake, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; 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.