Sebasticook Valley Health
Organization Active NPI Rural Health Clinic/Center · Newport, ME
NPI 1295367803 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1295367803
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 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
- Organization subpart
- Yes
- Parent organization (as reported)
- SEBASTICOOK VALLEY HEALTH
Authorized official
- Name
- Mr. Randall Clark
- Title
- VP of Finance
- Phone
- (207) 487-4000
Owners & managing parties with NPI records 2
-
Emily B Cianchette, FNP
-
Jeremy West, DC
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 4
Related certifications (CCN) 1
Change of ownership 1
Facilities with the same owner 15
Practitioners 35
-
Justin D Alley, CRNA
-
Reynaldo A Arceo, DO
-
Steven J Badeen, MD
-
Emily B Cianchette, FNP
-
Breanna Beth Conners, APRN
-
Charles A Crans Jr., M.D.
-
James W Douglas, DO
-
Simon A. L. Gibbs, M.D.
-
Donna R Huff, PMHNP-BC, PMHCNS-BC
-
Alan Jansujwicz, M.D.
-
Johannes Hendrik Jordaan, M.D.
-
Jerald Christopher Kuhn, M.D.
-
Catherin Marie L'Heureux, CRNA
-
Lori T Lalime, PMHNP
-
David Russell Langdon, M.D.
-
Yasmani Leyva Echevarria, CRNA
-
John F Moloney, M.D.
-
Heather Michelle Sevigny, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
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
- Corporation · Non-profit
- Incorporated
- Mar 4, 1963 in ME
- Enrollment address
- 26 Main St
Ste 2
Newport, ME 04953-4163 - Related CCNs
- 201313
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Stacey Fitts |
Corporate Director |
Jan 13, 2020 | |
| Emily B Cianchette |
Corporate Director |
Oct 1, 2023 | |
| Jeremy West |
Corporate Director |
Apr 27, 2020 | |
| Timothy J Dentry |
Corporate Officer |
Apr 1, 2020 | |
| Teresa Vieira |
Corporate Director |
Jan 27, 2025 | |
| Kady Huff |
Corporate Director |
Jun 26, 2023 | |
| Brett Danforth |
Corporate Director |
Nov 27, 2023 | |
| Eastern Maine Healthcare Services |
Operational/Managerial Control | Jan 13, 2020 | 100% |
| Kevin Cooley |
Corporate Director | Jun 23, 2025 | |
| Linda Woolley |
Corporate Director |
Jan 13, 2020 | |
| Charles Cianchette |
Corporate Director |
Jan 13, 2020 | |
| Stephen George |
Corporate Director |
Jun 23, 2025 | |
| Robin Chase |
Corporate Director |
Jan 13, 2020 | |
| Randall L. Clark |
Corporate Officer |
Apr 1, 2022 | |
| Operational/Managerial Control |
Apr 1, 2022 |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Jan 13, 2020 | Change of Ownership |
Newport Family Practice |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200310001975 | ME | Part a Provider - Rural Health Clinic | 3476462797 | Practice locations: Newport, ME |
National Provider Directory
- Tax ID family
- Sebasticook Valley Health
- Part of
- Sebasticook Valley Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | northerlighthealth.org | Health Information Exchange (HIE) | Sebasticook Valley Health |
Other providers in Newport, ME
- Michael S Saulter
- Sebasticook Dental Center
- Sebasticook Family Doctors
- Sebasticook Family Doctors
- Sebasticook Family Doctors
- Sensaitonal Minds: Early Learning Academy LLC
- Michael Anthony Shayne
- Karl F. Sitterly
- Kelley Sue Smith
- Laura G Stevens
All providers in Newport, ME · Rural Health Clinic/Center in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.