NPIMap

Organization Active NPI

Dexter Boarding Home

  • Custodial Care Facility
  • Dexter, ME
National Provider Identifier
1205070919
Registry record updated Apr 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
License
ALLS 2748 Issued in ME
Legal business name
DEXTER BOARDING HOME
Practice address
45 Main St
Dexter, ME 04930-1267
Phone
(207) 924-6211
Fax
(207) 924-7406
NPI assigned
Apr 24, 2009
Last updated
Apr 24, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
RAYMOND H BISHOPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2009

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

Authorized official

Name
Raymond H Bishop
Title
Owner
Phone
(207) 924-6211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X ALLS 2748 ME Primary

Addresses

Primary practice location

45 Main St
Dexter, ME 04930-1267

Mailing address

45 Main St
Dexter, ME 04930-1267
Phone (207) 924-6211

Other identifiers 1

IdentifierTypeStateIssuer
103580000MedicaidME

National Provider Directory

National Provider Directory
Tax ID family
Dexter Boarding Home2 organizations share this tax ID, including this one
Part of
Dexter Boarding Home

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240531200000",
    "number": "1205070919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MAIN ST",
            "city": "DEXTER",
            "state": "ME",
            "postal_code": "049301267",
            "telephone_number": "207-924-6211",
            "fax_number": "207-924-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MAIN ST",
            "city": "DEXTER",
            "state": "ME",
            "postal_code": "049301267",
            "telephone_number": "207-924-6211",
            "fax_number": "207-924-7406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEXTER BOARDING HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RAYMOND H BISHOP",
        "enumeration_date": "2009-04-24",
        "last_updated": "2009-04-24",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-924-6211"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "ME",
            "license": "ALLS 2748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103580000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dexter, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.