NPIMap

Organization Active NPI

Webber Hospital Association

  • Pediatrics Physician
  • Kennebunk, ME
National Provider Identifier
1194902809
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
WEBBER HOSPITAL ASSOCIATION
Practice address
2 Berry CT
Kennebunk, ME 04043-6812
Phone
(207) 985-8460
NPI assigned
Jan 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Frank Lavoie, MD
Title
VP Medical Affairs
Phone
(207) 283-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2 Berry CT
Kennebunk, ME 04043-6812

Mailing address

39 Wallace Ave
South Portland, ME 04106-6143
Phone (207) 985-8460

Other identifiers 2

IdentifierTypeStateIssuer
101580000MedicaidME
432732802MedicaidME

Other names 1

  • SMMC Pediatrics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040713001060 ME Part B Supplier - Clinic/Group Practice 0143208348 Receives reassigned benefits from 292 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sanford, ME; Saco, ME; Biddeford, ME; North Berwick, ME; Kennebunk, ME; East Waterboro, ME

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Locations

39 Wallace Ave
South Portland, ME 04106
Phone (207) 761-0650

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1194902809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WALLACE AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066143",
            "telephone_number": "207-985-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BERRY CT",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436812",
            "telephone_number": "207-985-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEBBER HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "LAVOIE",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "VP MEDICAL AFFAIRS",
        "authorized_official_telephone_number": "207-283-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101580000",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432732802",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMMC Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennebunk, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.