Organization Active NPI

Frannie Peabody Center

  • Community/Behavioral Health Agency
  • Portland, ME
National Provider Identifier
1184009128
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
683146 Issued in ME
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, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1992935662MedicaidME

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
20D1012191Frannie Peabody Center30 Danforth Street, Suite 309, Portland, ME 04101Certificate of waiverJul 14, 2028

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.