Individual provider Active NPI

Cassie McMullen, LPN

  • Licensed Practical Nurse
  • Bangor, ME
National Provider Identifier
1144969676
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN14730 Issued in ME
Practice address
689 Odlin Rd
Bangor, ME 04401-6709
Phone
(207) 947-6800
NPI assigned
Jun 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN14730 ME Primary

Addresses

Primary practice location

689 Odlin Rd
Bangor, ME 04401-6709

Mailing address

689 Odlin Rd
Bangor, ME 04401-6709
Phone (207) 947-6800

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EHR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN14730MEMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Discovery House BR, Inc. CurrentSince Jun 5, 2022 Accepting new patients

Locations

689 Odlin Rd
Bangor, ME 04401
Phone (207) 945-7765

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1144969676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "689 ODLIN RD",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016709",
            "telephone_number": "207-947-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 ODLIN RD",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016709",
            "telephone_number": "207-947-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMULLEN",
        "first_name": "CASSIE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "ME",
            "license": "LPN14730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "address_1": "689 Odlin Rd",
            "city": "Bangor",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044016709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.