Androscoggin Osteopathic, LLC,

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

DO2336 Issued in ME

Legal business name

ANDROSCOGGIN OSTEOPATHIC, LLC,

Practice address

95 Park St
Suite 519
Lewiston, ME 04240-7282

Phone

(207) 241-0945

Fax

(207) 241-0955

NPI assigned

Jul 30, 2014

Last updated

Mar 20, 2015By 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. Stephen R Bergman, DO

Title

Owner

Phone

(207) 241-0945

Specialties & licenses 1

Addresses

Other names 1

• Central Maine Osteopathic, LLC Former legal business name

Locations

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1144638412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 PARK ST",
            "address_2": "SUITE 519",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407282",
            "telephone_number": "207-241-0945",
            "fax_number": "207-241-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 PARK ST",
            "address_2": "SUITE 519",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407282",
            "telephone_number": "207-241-0945",
            "fax_number": "207-241-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDROSCOGGIN OSTEOPATHIC, LLC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-30",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "BERGMAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-241-0945",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "DO2336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Maine Osteopathic, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Neuromusculoskeletal Medicine & OMM Physician in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.