Islands Community Medical Services Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

ISLANDS COMMUNITY MEDICAL SERVICES INC

Doing business as

Islands Community Medical Center

Practice address

15 Medical Center Loop
Vinalhaven, ME 04863

Phone

(207) 863-4341

Fax

(207) 863-9358

NPI assigned

Jun 30, 2006

Last updated

Oct 7, 2024By 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

Dinah B Moyer

Title

Executive Director

Phone

(207) 863-9071

Specialties & licenses 1

Addresses

Other names 1

• Islands Community Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in ME2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265460794. Details of each certification follow.

• CCN 201835 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 201835

Legal name

ISLANDS COMMUNITY MEDICAL SERVICES INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 16, 2003

Last certification

Apr 16, 2003

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Jun 19, 1946 in ME

Enrollment address

15 Medical Center Loop
Vinalhaven, ME 48634119

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 10

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.

• Jennifer S Desmond, FNP

  • Nurse Practitioner
  • Vinalhaven, ME
  • NPI 1851480305
  Medicare reassignment Care Compare group NPD
• Dana A Keniston, LCSW

  • Clinical Social Worker
  • Liberty, ME
  • NPI 1427346675
  Medicare reassignment Care Compare group NPD
• Vanessa Shields-Haas, FNP-C

  • Family Nurse Practitioner
  • Rockland, ME
  • NPI 1982281143
  Medicare reassignment Care Compare group NPD
• Stuart N Damon, D.O.

  • Family Medicine Physician
  • Boothbay Harbor, ME
  • NPI 1841383734
  Medicare reassignment Care Compare group
• James E Hogan, RPA-C

  • Physician Assistant
  • Vinalhaven, ME
  • NPI 1639189590
  Medicare reassignment Care Compare group
• Tisa Massey Parsons, CRNP

  • Family Nurse Practitioner
  • Princess Anne, MD
  • NPI 1528619509

  ME

  Medicare reassignment Care Compare group
• John Kroger, MD

  • Family Medicine Physician
  • Rumford, ME
  • NPI 1538131024
  Medicare reassignment NPD
• Peter Levandoski, DMD

  • General Practice Dentistry
  • Bangor, ME
  • NPI 1770915563
  Medicare reassignment NPD
• Taylor Littlefield

  • Physical Therapist
  • Vinalhaven, ME
  • NPI 1821720392
  Medicare reassignment NPD
• Nancy Alexandra Caffrey, PA-C

  • Medical Physician Assistant
  • Ticonderoga, NY
  • NPI 1962551150

  ME

  Medicare reassignment

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1265460794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MEDICAL CENTER LOOP",
            "city": "VINALHAVEN",
            "state": "ME",
            "postal_code": "04863",
            "telephone_number": "207-863-4341",
            "fax_number": "207-863-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MEDICAL CENTER LOOP",
            "city": "VINALHAVEN",
            "state": "ME",
            "postal_code": "04863",
            "telephone_number": "207-863-4341",
            "fax_number": "207-863-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLANDS COMMUNITY MEDICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "MOYER",
        "authorized_official_first_name": "DINAH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "207-863-9071"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Islands Community Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Islands Community Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Guptill, RN
• James E Hogan, RPA-C
• Maryann Hopkins, SLP
• Island Community Medical Services - Dental
• Islands Community Medical Services
• Islands Community Medical Services, Inc.
• Taylor Littlefield
• Sarah McDonald
• Erwin L Morse, PA
• Samanatha Quinn I, RDH

• Federally Qualified Health Center (FQHC) in Vinalhaven, ME
• Providers in Vinalhaven, ME by specialty
• Federally Qualified Health Center (FQHC) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.