NPIMap

Organization Active NPI

State of Maine

Doing business as Dorothea Dix Psychiatric Center Out Patient Services

  • Community/Behavioral Health Agency
  • Bangor, ME
National Provider Identifier
1184020091
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
681294 Issued in ME
Legal business name
STATE OF MAINE
Doing business as
Dorothea Dix Psychiatric Center Out Patient Services
Practice address
656 State St
Bangor, ME 04401-5609
Phone
(207) 287-7418
Fax
(207) 287-1862
NPI assigned
Nov 5, 2014
Last updated
Jun 14, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Authorized official

Name
Carol Webb Cody
Title
Financial Manager
Phone
(207) 941-4192

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 681294 ME Primary

Addresses

Primary practice location

656 State St
Bangor, ME 04401-5609

Mailing address

109 Capitol Street SHS #11, Reimbursement Unit
Augusta, ME 04333-0011
Phone (207) 287-7418

Other names 1

  • Dorothea Dix Psychiatric Center Out Patient Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610001611 ME Part B Supplier - Clinic/Group Practice 7517875131 Receives reassigned benefits from 99 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Augusta, ME; Bangor, ME

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Pineland Center8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

656 State St
Bangor, ME 04401
Phone (207) 941-4000

Practitioners & affiliated clinicians

Practitioners 7

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": "1415145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560470400000",
    "number": "1184020091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CAPITOL STREET SHS #11, REIMBURSEMENT UNIT",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043330011",
            "telephone_number": "207-287-7418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015609",
            "telephone_number": "207-287-7418",
            "fax_number": "207-287-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MAINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-05",
        "last_updated": "2019-06-14",
        "status": "A",
        "authorized_official_last_name": "CODY",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "WEBB",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "207-941-4192"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ME",
            "license": "681294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dorothea Dix Psychiatric Center Out Patient Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dorothea Dix Psychiatric Center Out Patient Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.