Individual provider Active NPI

Erika N Wentworth, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bangor, ME
National Provider Identifier
1255080032
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP221075 Issued in ME
Practice address
1012 Union St
Bangor, ME 04401-3060
Phone
(207) 404-8100
NPI assigned
Mar 21, 2022
Last updated
Sep 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP221075 ME Primary

Addresses

Primary practice location

1012 Union St
Bangor, ME 04401-3060

Mailing address

PO Box 1599
Bangor, ME 04402-1599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220504000293 ME Practitioner - Nurse Practitioner 0840687216 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penobscot Community Health CenterGroup PAC ID 0143212670, 135 clinicians

Practice addresses (Care Compare)

1012 Union St
Bangor, ME 04401-3058

1068 Union St
Bangor, ME 04401-3016
Phone (207) 404-8181

992 Union St
Bangor, ME 04401-3057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP221075MEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Penobscot Community Health Center CurrentSince Aug 1, 2022 Accepting new patients
Acadia Hospital Corp CurrentSince Mar 27, 2022 Accepting new patients
Penobscot Community Health Center CurrentSince Aug 1, 2022 Accepting new patients
Acadia Healthcare, Inc Past Accepting new patients

Locations

1012 Union St
Bangor, ME 04401
Phone (207) 404-8200

1012 Union St
Ste 1
Bangor, ME 04401
Phone 2079455247407

268 Stillwater Ave
Bangor, ME 04401
Phone (207) 973-6470

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1255080032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 UNION ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013060",
            "telephone_number": "207-404-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTWORTH",
        "first_name": "ERIKA",
        "middle_name": "N",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP221075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.