Kenneth G Christian, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

012244 Issued in ME

Practice address

70 Kingsland Xing Ste a
Ellsworth, ME 04605-2570

Phone

(207) 664-5340

Fax

(207) 664-5338

NPI assigned

May 27, 2006

Sex

Male

Sole proprietor

No

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

• Goodwins Mills Rescue

  • Land Ambulance
  • Lyman, ME
  • NPI 1043243579
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 20, 2022.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1194772970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 SOUTH RD",
            "city": "HOLDEN",
            "state": "ME",
            "postal_code": "044297531",
            "telephone_number": "207-949-5700",
            "fax_number": "207-664-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 KINGSLAND XING STE A",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046052570",
            "telephone_number": "207-664-5340",
            "fax_number": "207-664-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIAN",
        "first_name": "KENNETH",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "ME",
            "license": "012244",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ME",
            "license": "012244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Child and Family Opportunities, Inc
• Child Development Services-Hancock County
• Children, Families and Communities, Inc.
• Lisa Chilgreen, PTA
• Traci Christensen-Johnson
• City of Ellsworth
• City of Ellsworth
• City of Ellsworth
• Jesse R Cloutier, PA
• Nicki Clukey

• All providers in Ellsworth, ME
• Emergency Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.