Ronald Phillip Small

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

ALLS3410 Issued in ME

Practice address

316 Main St
Corinth, ME 04427-3031

Phone

(207) 285-3281

NPI assigned

Sep 8, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1194058313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "city": "CORINTH",
            "state": "ME",
            "postal_code": "044270129",
            "telephone_number": "207-285-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 MAIN ST",
            "city": "CORINTH",
            "state": "ME",
            "postal_code": "044273031",
            "telephone_number": "207-285-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "RONALD",
        "middle_name": "PHILLIP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-08",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "ALLS3410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200550000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elaine Ann Ouellette, OTA/L
• Heidi Marie Plourde, LCPC, LSW
• Lucille E. Potter, LMT
• Anette Poulin, PAC
• Madison Pullen, FNP
• SV Therapy, LLC
• Town of Corinth
• Sara Rose Ventriglia, LCPC-C
• Jana Marie Watson, CCC-SLP
• Dale A White, DSP, CRMA

• All providers in Corinth, ME
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.