Lisbon Emergency Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

422 Issued in ME

Legal business name

LISBON EMERGENCY INC

Practice address

42 Village St
Lisbon, ME 04250-6422

Phone

(207) 353-4079

NPI assigned

Jun 20, 2006

Organization subpart

No

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

Authorized official

Name

James Macdonnell

Title

Chief

Phone

(207) 353-4079

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352764800000",
    "number": "1154367241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "04062",
            "telephone_number": "207-892-0020",
            "fax_number": "207-893-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 VILLAGE ST",
            "city": "LISBON",
            "state": "ME",
            "postal_code": "042506422",
            "telephone_number": "207-353-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISBON EMERGENCY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2012-11-13",
        "status": "A",
        "authorized_official_last_name": "MACDONNELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "207-353-4079"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ME",
            "license": "422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175850000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "002247",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna L Fultz, NP-C
• Mariette Marie Hanlon, LCSW
• Heartful Homes Care LLC
• Inspire Well LLC
• Katelyn Jacques, CCC-SLP
• Deepa Patel
• Gina Marie Penka Corriveau, CPM, IBCLC
• Katelyn Peschier, LADC, MHRT/C-P
• Lisa E Polakowski, LMSW-CC
• Pamela Pariser Rasmussen

• Land Ambulance in Lisbon, ME
• Providers in Lisbon, ME by specialty
• Land Ambulance in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.