NPIMap

Organization Active NPI

Tom Negron, PH.D, PA

  • Clinical Psychologist
  • Gorham, ME
National Provider Identifier
1194973131
Registry record updated Nov 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY712 Issued in ME
Legal business name
TOM NEGRON, PH.D, PA
Practice address
4 Cummings Dr
Gorham, ME 04038-2452
Phone
(207) 772-1164
Fax
(207) 772-2670
NPI assigned
Sep 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2021

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

Authorized official

Name
Dr. Tom Negron, PH.D.
Title
President
Phone
(207) 772-1164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PSY712 ME Primary

Addresses

Primary practice location

4 Cummings Dr
Gorham, ME 04038-2452

Mailing address

PO Box 788
Windham, ME 04062-0788
Phone (207) 772-1164

Other names 1

  • tom negron, ph.d. Doing business as

National Provider Directory

National Provider Directory

Locations

178 Middle St
Ste 300
Portland, ME 04101
Phone (207) 772-1164

Practitioners & affiliated clinicians

Practitioners 7

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": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636243200000",
    "number": "1194973131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040620788",
            "telephone_number": "207-772-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CUMMINGS DR",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040382452",
            "telephone_number": "207-772-1164",
            "fax_number": "207-772-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOM NEGRON, PH.D, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2021-11-07",
        "certification_date": "2021-11-07",
        "status": "A",
        "authorized_official_last_name": "NEGRON",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-772-1164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PSY712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "tom negron, ph.d.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gorham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2021; 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.