Individual provider Active NPI

Audra Lynn Debethune, WHNP

  • Women's Health Nurse Practitioner
  • South Portland, ME
National Provider Identifier
1265276349
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
CNP251413 Issued in ME
Practice address
102 Dawson St
South Portland, ME 04106-3439
Phone
(207) 749-4140
NPI assigned
Jun 24, 2024
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X CNP251413 ME Primary

Addresses

Primary practice location

102 Dawson St
South Portland, ME 04106-3439

Mailing address

102 Dawson St
South Portland, ME 04106-3439
Phone (207) 749-4140

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
I20251113002718 ME Practitioner - Nurse Practitioner 8820589237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

195 Fore River Pkwy
Suite 310
Portland, ME 04102-2785
Phone (207) 553-6920

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP251413MEMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital CurrentSince Oct 12, 2025 Accepting new patients
Mercy Hospital CurrentSince Oct 12, 2025 Accepting new patients

Locations

195 Fore River Pkwy
Ste 310
Portland, ME 04102
Phone (207) 523-5901

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1265276349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 DAWSON ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063439",
            "telephone_number": "207-749-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 DAWSON ST",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063439",
            "telephone_number": "207-749-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBETHUNE",
        "first_name": "AUDRA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-24",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "ME",
            "license": "CNP251413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

Verify at the official NPI Registry.