NPIMap

Organization Active NPI

Sebasticook Valley Health

  • Rural Health Clinic/Center
  • Newport, ME
National Provider Identifier
1295367803
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SEBASTICOOK VALLEY HEALTH
Practice address
26 Main St Ste 2
Newport, ME 04953-4163
Phone
(207) 368-5747
Fax
(207) 368-5483
NPI assigned
Feb 11, 2020
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SEBASTICOOK VALLEY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Mr. Randall Clark
Title
VP of Finance
Phone
(207) 487-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

26 Main St Ste 2
Newport, ME 04953-4163

Mailing address

447 N Main St
Pittsfield, ME 04967-3707
Phone (207) 487-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL northerlighthealth.org Health Information Exchange (HIE) Sebasticook Valley Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200310001975 ME Part A Provider - Rural Health Clinic 3476462797 Practice locations: Newport, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295367803. Details of each certification follow.

Rural health clinic certification: CCN 208528

Legal name
SEBASTICOOK VALLEY HEALTH
Doing business as
NORTHERN LIGHT SEBASTICOOK VALLEY HOSPITAL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 13, 2020
Last certification
Apr 7, 2021
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Mar 4, 1963 in ME
Enrollment address
26 Main St
Ste 2
Newport, ME 04953-4163
Related CCNs
201313

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Steven J Badeen MD5 organizations share this tax ID, including this one
Part of
Steven J Badeen MD

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Stacey Fitts Individual Corporate DirectorBoard Member Jan 13, 2020
Emily B Cianchette Individual Corporate DirectorBoard Member Oct 1, 2023
Jeremy West Individual Corporate DirectorBoard Member Apr 27, 2020
Timothy J Dentry Individual Corporate OfficerPresident & Ceo of Emhs Apr 1, 2020
Teresa Vieira Individual Corporate DirectorBoard Member Jan 27, 2025
Kady Huff Individual Corporate DirectorBoard Member Jun 26, 2023
Brett Danforth Individual Corporate DirectorBoard Member Nov 27, 2023
Eastern Maine Healthcare Services Organization, Brewer, ME Non-profit Operational/Managerial Control Jan 13, 2020 100%
Kevin Cooley Individual Corporate Director Jun 23, 2025
Linda Woolley Individual Corporate DirectorBoard Member Jan 13, 2020
Charles Cianchette Individual Corporate DirectorBoard Member Jan 13, 2020
Stephen George Individual Corporate DirectorBoard Member Jun 23, 2025
Robin Chase Individual Corporate DirectorBoard Member Jan 13, 2020
Randall L. Clark Individual Corporate OfficerPresident Apr 1, 2022
Operational/Managerial ControlPresident Apr 1, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 15

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 15

Change-of-ownership history 1

DateEventCounterparty
Jan 13, 2020 Change of OwnershipThis provider was the buyer Newport Family PracticeCCN 203857, ME, NPI 1760450910

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1295367803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 N MAIN ST",
            "city": "PITTSFIELD",
            "state": "ME",
            "postal_code": "049673707",
            "telephone_number": "207-487-4000",
            "fax_number": "207-487-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 MAIN ST STE 2",
            "city": "NEWPORT",
            "state": "ME",
            "postal_code": "049534163",
            "telephone_number": "207-368-5747",
            "fax_number": "207-368-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEBASTICOOK VALLEY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEBASTICOOK VALLEY HEALTH",
        "enumeration_date": "2020-02-11",
        "last_updated": "2023-11-27",
        "certification_date": "2020-03-20",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "207-487-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "northerlighthealth.org",
            "affiliation": "Y",
            "affiliationName": "Sebasticook Valley Health",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "447 N Main St",
            "city": "Pittsfield",
            "state": "ME",
            "country_code": "US",
            "postal_code": "049673707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newport, ME

Sources for this page

Verify at the official NPI Registry.