NPIMap

Individual provider Active NPI

Loretta A Hothersall, FNP

  • Nurse Practitioner
  • Scarborough, ME
National Provider Identifier
1174635817
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R033570 Issued in ME
Practice address
71 US Route 1 Ste J
Scarborough, ME 04074-7168
Phone
(207) 396-6433
Fax
(207) 396-6436
NPI assigned
Aug 31, 2006
Last updated
Jan 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R033570 ME Primary

Addresses

Primary practice location

71 US Route 1 Ste J
Scarborough, ME 04074-7168

Mailing address

71 US Route 1 Ste J
Scarborough, ME 04074-7168
Phone (207) 396-6433

Other identifiers 1

IdentifierTypeStateIssuer
293030099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040520000582 ME Practitioner - Nurse Practitioner 4183615958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

57 Portland Rd
Kennebunk, ME 04043-6661
Phone (207) 831-6255

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R033570MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Duprey Consultants LLC CurrentSince Jan 26, 2019 Accepting new patients
Optima Dermatology LLC CurrentSince Apr 18, 2022 Accepting new patients
Hothersall Consultants LLC Nurse Practitioner CurrentSince Dec 14, 2017 Accepting new patients
Maine Medical Partners Past Accepting new patients

Locations

57 Portland Rd
Kennebunk, ME 04043
Phone (207) 467-3777

57 Portland Rd
Ste 5
Kennebunk, ME 04043
Phone (207) 467-3777

71 US Route 1
Ste J
Scarborough, ME 04074
Phone (207) 464-2712

Organizations & group practices 4

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

Hospital & facility affiliations 37

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1174635817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 US ROUTE 1 STE J",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747168",
            "telephone_number": "207-396-6433",
            "fax_number": "207-396-6436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 US ROUTE 1 STE J",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747168",
            "telephone_number": "207-396-6433",
            "fax_number": "207-396-6436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOTHERSALL",
        "first_name": "LORETTA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "R033570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293030099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.