NPIMap

Organization Active NPI

Northern Maine Medical Center

Doing business as Forest Hill

  • Skilled Nursing Facility
  • Fort Kent, ME
National Provider Identifier
1174519490
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
36151 Issued in ME
Legal business name
NORTHERN MAINE MEDICAL CENTER
Doing business as
Forest Hill
Practice address
25 Bolduc Ave
Fort Kent, ME 04743-1601
Phone
(207) 834-3915
Fax
(207) 834-5538
NPI assigned
Sep 22, 2005
Last updated
Sep 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Authorized official

Name
Mr. Jeffrey Zewe
Title
Ceo
Phone
(207) 834-1411

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 36151 ME
Skilled Nursing Facility 314000000X 36151 ME Primary

Addresses

Primary practice location

25 Bolduc Ave
Fort Kent, ME 04743-1601

Mailing address

25 Bolduc Ave
Fort Kent, ME 04743-1601
Phone (207) 834-3915

Other identifiers 2

IdentifierTypeStateIssuer
031150OtherMEANTHEM BLUE CROSS & BS
1174519490MedicaidME

Other names 1

  • Forest Hill Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040602001068 ME Part A Provider - Skilled Nursing Facility 8426952987 Practice locations: Fort Kent, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174519490. Details of each certification follow.

Skilled nursing facility certification: CCN 205176

Legal name
NORTHERN MAINE MEDICAL CENTER
Doing business as
FOREST HILL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 1, 1994
Last certification
Feb 20, 2025
Beds
45
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 5, 1940 in ME
Enrollment address
25 Bolduc Ave
Fort Kent, ME 04743-1601
Nursing home name
FOREST HILL MANOR

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Forest Hill ManorCCN 205176 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Mar 1, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4544.7 residents per day on average
Penalties (3 years)
1Fines totaling $13,627

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0697823NMMC Forest Hill Manor25 Bolduc Ave, Fort Kent, ME 04743Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Northern Maine Medical Cent12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

25 Bolduc Ave
Fort Kent, ME 04743
Phone (207) 834-3387

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gisele Dionne Individual Corporate DirectorBoard Member Jan 30, 2019
Managing Control - Governing BodyBoard Member Jan 30, 2019
Stephanie D Gillis Individual Operational/Managerial Control Nov 1, 2022
Adp of the SNF Nov 1, 2022
Lucie Tabor Individual Corporate DirectorBoard Member Jan 15, 2021
Managing Control - Governing BodyBoard Member Jan 15, 2021
Daniel Vaillancourt Individual Corporate DirectorBoard Member Jan 1, 2020
Managing Control - Governing BodyBoard Member Jan 1, 2020
John Ezzy Individual Corporate DirectorBoard Member Jan 1, 2022
Managing Control - Governing BodyBoard Member Jan 1, 2022
Steven Ouellette Individual Corporate DirectorBoard Member Jan 15, 2021
Managing Control - Governing BodyBoard Member Jan 15, 2021
Jeffrey Zewe Individual Corporate OfficerCeo May 1, 2022
Operational/Managerial Control May 1, 2022
Adp of the SNF Jul 12, 2024
Aaron Teachout Individual Corporate OfficerCfo & Treasurer Sep 30, 2021
Operational/Managerial Control Sep 30, 2021
Adp of the SNF Jul 12, 2024
Norman L Fournier Individual Corporate DirectorBoard Member Jan 15, 2021
Managing Control - Governing BodyBoard Member Jan 15, 2021
Donald Guimond Individual Corporate DirectorBoard Member Jul 21, 2015
Managing Control - Governing BodyBoard Chair Jul 21, 2015
Erin Soucy Individual Corporate DirectorBoard Member Jun 28, 2016
Managing Control - Governing BodyVice Chair Jun 28, 2016
Douglas Cyr Individual Corporate DirectorBoard Member Jan 1, 2020
Managing Control - Governing BodyBoard Member Jan 1, 2020
Alain Bois Individual Corporate OfficerCoo Mar 29, 2021
Operational/Managerial Control Jul 12, 2024
Adp of the SNF Jul 12, 2024
James V Harris Individual Corporate DirectorBoard Member Jun 20, 2023
Managing Control - Governing BodyBoard Member Jun 20, 2023
Steven Pelletier Individual Corporate DirectorBoard Member Jan 1, 2018
Managing Control - Governing BodyBoard Member Jan 1, 2018

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 3

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": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1174519490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 BOLDUC AVE",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "047431601",
            "telephone_number": "207-834-3915",
            "fax_number": "207-834-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BOLDUC AVE",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "047431601",
            "telephone_number": "207-834-3915",
            "fax_number": "207-834-5538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MAINE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "ZEWE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-834-1411",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "ME",
            "license": "36151",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ME",
            "license": "36151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS & BS",
            "identifier": "031150",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174519490",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Hill",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Forest Hill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Kent, ME

Sources for this page

Verify at the official NPI Registry.