NPIMap

Organization Active NPI

Penobscot Community Health Center

Doing business as PCHC Walk In - Seaport

  • Urgent Care Clinic/Center
  • Belfast, ME
National Provider Identifier
1265863161
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PENOBSCOT COMMUNITY HEALTH CENTER
Doing business as
PCHC Walk In - Seaport
PCHC Walk In Seaport
Practice address
21 Schoodic Dr
Belfast, ME 04915-7246
Phone
(207) 338-6900
NPI assigned
Dec 3, 2013
Last updated
Apr 22, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
PENOBSCOT COMMUNITY HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Authorized official

Name
Lori L. Dwyer, ESQ.
Title
President & Ceo
Phone
(207) 992-9200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU
Urgent Care Clinic/Center 261QU0200X NU Primary
Family Medicine Physician 207Q00000X ME

Addresses

Primary practice location

21 Schoodic Dr
Belfast, ME 04915-7246

Mailing address

PO Box 1599
Bangor, ME 04402-1599
Phone (207) 945-5247

Other names 2

  • PCHC Walk In - Seaport Doing business as
  • PCHC Walk In Seaport Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Manna Inc40 organizations share this tax ID, including this one
Part of
Manna Inc

Other organizations with this tax ID 39

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

View all 39

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1265863161",
    "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",
            "telephone_number": "207-945-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SCHOODIC DR",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049157246",
            "telephone_number": "207-338-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENOBSCOT COMMUNITY HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENOBSCOT COMMUNITY HEALTH CENTER",
        "enumeration_date": "2013-12-03",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "207-992-9200",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCHC Walk In - Seaport",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PCHC Walk In Seaport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belfast, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.