NPIMap

Organization Active NPI

Hospital Osteopathic Manipulative Medicine PC

  • Neuromusculoskeletal Medicine & OMM Physician
  • Portland, ME
National Provider Identifier
1144706615
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
Legal business name
HOSPITAL OSTEOPATHIC MANIPULATIVE MEDICINE PC
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 347-3164
NPI assigned
Jul 17, 2018
Last updated
Jul 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Authorized official

Name
David D Keller, DONPI 1861448201
Title
Owner
Phone
(207) 347-3164

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X NU Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

195 Fore River Pkwy Ste 470
Portland, ME 04102-2787
Phone (207) 347-3164

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181113000862 ME Part B Supplier - Clinic/Group Practice 2365796273 Receives reassigned benefits from 12 practitioners
Practice locations: Portland, ME

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1144706615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 FORE RIVER PKWY STE 470",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022787",
            "telephone_number": "207-347-3164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-347-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL OSTEOPATHIC MANIPULATIVE MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-347-3164",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.