NPIMap

Organization Active NPI

Fore River Family Medicine, PA

  • Family Medicine Physician
  • Portland, ME
National Provider Identifier
1144420332
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
012111 Issued in ME
Legal business name
FORE RIVER FAMILY MEDICINE, PA
Practice address
51 Sewall St
Portland, ME 04102-2643
Phone
(207) 772-8823
Fax
(207) 772-1856
NPI assigned
Jul 25, 2007
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Catherine CruteNPI 1508834441
Title
President/ Owner
Phone
(207) 772-8823

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 012111 ME Primary

Addresses

Primary practice location

51 Sewall St
Portland, ME 04102-2643

Mailing address

51 Sewall St
Portland, ME 04102-2643
Phone (207) 772-8823

Other identifiers 4

IdentifierTypeStateIssuer
B86348OtherMEHARVARD PILGRIM
2449295OtherMEAETNA
8892325OtherMECIGNA
099071OtherMEANTHEM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1144420332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022643",
            "telephone_number": "207-772-8823",
            "fax_number": "207-772-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 SEWALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022643",
            "telephone_number": "207-772-8823",
            "fax_number": "207-772-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORE RIVER FAMILY MEDICINE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "CRUTE",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "PRESIDENT/ OWNER",
        "authorized_official_telephone_number": "207-772-8823"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "012111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "B86348",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2449295",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8892325",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "099071",
            "state": "ME"
        }
    ],
    "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 Apr 20, 2008; 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.