Lisa Belanger, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP81142 Issued in ME

Practice address

37 College Ave
125 Upton Hall
Gorham, ME 04038-1032

Phone

(207) 780-5411

NPI assigned

Mar 20, 2007

Last updated

May 25, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• University of Maine System

  dba University of Southern Maine

  • Student Health Clinic/Center
  • Gorham, ME
  • NPI 1780020941
  NPD (past) Authorized official
• University of Southern Maine

  dba Health & Counseling Services

  • Primary Care Nurse Practitioner
  • Gorham, ME
  • NPI 1518201250
  NPD (past) Authorized official
• Maine Behavioral Healthcare

  • Community/Behavioral Health Agency
  • Portland, ME
  • NPI 1962422964
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1285759993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 LISAS WAY",
            "city": "NORTH YARMOUTH",
            "state": "ME",
            "postal_code": "040976075",
            "telephone_number": "207-657-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 COLLEGE AVE",
            "address_2": "125 UPTON HALL",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381032",
            "telephone_number": "207-780-5411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELANGER",
        "first_name": "LISA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP81142",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "R021136",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "324760099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "305647",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "M2048203",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "39362",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diego Barbosa Da Silva, IPDH, RDH
• Linda D. Beagle, M.A., CCC-SLP
• Elizabeth Anne Beane, LCSW
• Abby M Beaumont, LCSW
• Elizabeth Beaven
• Amber S Bell, P.T.
• Mary Kathryn Frey Bennett, DPT
• Kirsten Bombardier Benson
• Brandi Marie Bessey
• Alana Bickford Patterson

• Family Nurse Practitioner in Gorham, ME
• Providers in Gorham, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; 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.