Active NPI
Frannie Peabody Center
- Community/Behavioral Health Agency
- Portland, ME
National Provider Identifier
1184009128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 683146
- Legal business name
- FRANNIE PEABODY CENTER
- Practice address
- 30 Danforth St Ste 311
Portland, ME 04101-4574 - Phone
- (207) 774-6877
- Fax
- (207) 879-0761
- NPI assigned
- Jul 20, 2015
- Last updated
- Jul 20, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. John Fitzgerald Joanette
- Title
- Operations Director
- Phone
- (207) 774-6877
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 683146 | ME | Primary |
Addresses
Primary practice location
30 Danforth St Ste 311
Portland, ME 04101-4574
Mailing address
30 Danforth St Ste 311
Portland, ME 04101-4574
Phone (207) 774-6877
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992935662 | Medicaid | ME |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 20D1012191 | Frannie Peabody Center | Certificate of waiver | Jul 14, 2028 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437350400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1437350400000",
"number": "1184009128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 DANFORTH ST STE 311",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041014574",
"telephone_number": "207-774-6877",
"fax_number": "207-879-0761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 DANFORTH ST STE 311",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041014574",
"telephone_number": "207-774-6877",
"fax_number": "207-879-0761"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRANNIE PEABODY CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2015-07-20",
"last_updated": "2015-07-20",
"status": "A",
"authorized_official_last_name": "JOANETTE",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "FITZGERALD",
"authorized_official_title_or_position": "OPERATIONS DIRECTOR",
"authorized_official_telephone_number": "207-774-6877",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "ME",
"license": "683146",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1992935662",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.