Valley Medical Association

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VALLEY MEDICAL ASSOCIATION

Doing business as

Long Lake Regional Health Center

Practice address

384 Main St
St Agatha, ME 04772

Phone

(207) 543-7567

NPI assigned

Jan 17, 2006

Last updated

May 17, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Peter Sirois

Title

Ceo

Phone

(207) 834-1408

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Long Lake Regional Health Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Asif Ansari, MD

  • Hospitalist Physician
  • Greenwood, IN
  • NPI 1760471080

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305590400000",
    "number": "1245219351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 E MAIN ST",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "04743",
            "telephone_number": "207-834-5877",
            "fax_number": "207-834-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 MAIN ST",
            "city": "ST AGATHA",
            "state": "ME",
            "postal_code": "04772",
            "telephone_number": "207-543-7567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY MEDICAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2011-05-17",
        "status": "A",
        "authorized_official_last_name": "SIROIS",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-834-1408",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165800103",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Lake Regional Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Haleigh Jipson, MSOT, OTR/L
• Marion Michaud, DSP/CRMA
• Joanne Denise O'Leary, DNP-RN, NCSN

• Internal Medicine Physician in St. Agatha, ME
• Providers in St. Agatha, ME by specialty
• Internal Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; 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.