Active NPI
Jason G Lanouette, PT
- Physical Therapist
- Portland, ME
National Provider Identifier
1275502056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 799
- Practice address
- 94 Auburn Street
#103
Portland, ME 04103 - Phone
- (207) 797-7578
- Fax
- (207) 797-8165
- NPI assigned
- Mar 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 799 | ME | Primary |
Addresses
Primary practice location
94 Auburn Street
#103
Portland, ME 04103
Mailing address
3 Carnoustie Drive
Falmouth, ME 04105
Phone (207) 878-8925
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036569 | Other | ANTHEM |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 799 | ME | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1275502056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 CARNOUSTIE DRIVE",
"city": "FALMOUTH",
"state": "ME",
"postal_code": "04105",
"telephone_number": "207-878-8925",
"fax_number": "207-797-8165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "94 AUBURN STREET",
"address_2": "#103",
"city": "PORTLAND",
"state": "ME",
"postal_code": "04103",
"telephone_number": "207-797-7578",
"fax_number": "207-797-8165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANOUETTE",
"first_name": "JASON",
"middle_name": "G",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-15",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "799",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "036569",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.