Individual provider Active NPI

Joseph Peterson

  • Pharmacist
  • Mechanic Falls, ME
National Provider Identifier
1275120180
Registry record updated Dec 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PR5625 Issued in ME
Practice address
50 Pigeon Hill Rd
Mechanic Falls, ME 04256-5726
Phone
(207) 998-2650
Fax
(207) 998-2670
NPI assigned
Dec 26, 2020
Last updated
Dec 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PR5625 ME Primary

Addresses

Primary practice location

50 Pigeon Hill Rd
Mechanic Falls, ME 04256-5726

Mailing address

50 Pigeon Hill Rd
Mechanic Falls, ME 04256-5726
Phone (207) 998-2650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PR5625MEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hannaford Bros. Co., LLC PastSince Jan 3, 2021 Accepting new patients
Hannaford Bros Co LLC PastSince Jan 3, 2021 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1608940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608940800000",
    "number": "1275120180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PIGEON HILL RD",
            "city": "MECHANIC FALLS",
            "state": "ME",
            "postal_code": "042565726",
            "telephone_number": "207-998-2650",
            "fax_number": "207-998-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 PIGEON HILL RD",
            "city": "MECHANIC FALLS",
            "state": "ME",
            "postal_code": "042565726",
            "telephone_number": "207-998-2650",
            "fax_number": "207-998-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-26",
        "last_updated": "2020-12-26",
        "certification_date": "2020-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ME",
            "license": "PR5625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanic Falls, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2020; 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.