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Organization Active NPI

Cape Elizabeth Family Medicine, LLC

  • Family Medicine Physician
  • Cape Elizabeth, ME
National Provider Identifier
1154543130
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CAPE ELIZABETH FAMILY MEDICINE, LLC
Practice address
1226 Shore Rd
Cape Elizabeth, ME 04107-2123
Phone
(207) 799-4050
Fax
(207) 799-4758
NPI assigned
May 2, 2007
Last updated
Dec 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

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

Authorized official

Name
Dr. Craig E Johnson, M.D.
Title
Owner
Phone
(207) 799-4050

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Family Nurse Practitioner 363LF0000X
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X

Addresses

Primary practice location

1226 Shore Rd
Cape Elizabeth, ME 04107-2123

Mailing address

301 US Route 1
Building C
Scarborough, ME 04074-7609
Phone (207) 396-8600

Other identifiers 1

IdentifierTypeStateIssuer
135170000MedicaidME

National Provider Directory

National Provider Directory

Locations

1226 Shore Rd
Cape Elizabeth, ME 04107
Phone (207) 699-0901

Practitioners & affiliated clinicians

Practitioners 5

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": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293580800000",
    "number": "1154543130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 US ROUTE 1",
            "address_2": "BUILDING C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747609",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 SHORE RD",
            "city": "CAPE ELIZABETH",
            "state": "ME",
            "postal_code": "041072123",
            "telephone_number": "207-799-4050",
            "fax_number": "207-799-4758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPE ELIZABETH FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2010-12-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-799-4050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135170000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Elizabeth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; 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.