Individual provider Active NPI

Stephanie M Thompson, CFNP

  • Family Nurse Practitioner
  • Bangor, ME
National Provider Identifier
1306609417
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP241082 Issued in ME
Practice address
6 Telcom Dr FL 2
Bangor, ME 04401-3072
Phone
(207) 947-0147
Fax
(207) 903-3659
NPI assigned
Feb 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP241082 ME Primary

Addresses

Primary practice location

6 Telcom Dr FL 2
Bangor, ME 04401-3072

Mailing address

PO Box 1599
Bangor, ME 04402-1599
Phone (207) 404-8200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240307003330 ME Practitioner - Nurse Practitioner 4486090800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penobscot Community Health CenterGroup PAC ID 0143212670, 135 clinicians

Practice addresses (Care Compare)

6 Telcom Dr
Bangor, ME 04401-3072
Phone (207) 941-2850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Penobscot Community Health Center CurrentSince Mar 1, 2024 Accepting new patients
Penobscot Community Health Center Current Accepting new patients
Penobscot Community Health Center CurrentSince Mar 1, 2024 Accepting new patients

Locations

6 Telcom Dr
Bangor, ME 04401
Phone (207) 941-2850

6 Telcom Dr
Fl 2
Bangor, ME 04401
Phone (207) 947-0147

1012 Union St
Ste 1
Bangor, ME 04401
Phone 2079455247407

1012 Union St
Bangor, ME 04401
Phone (207) 404-8200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1306609417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-404-8200",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TELCOM DR FL 2",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013072",
            "telephone_number": "207-947-0147",
            "fax_number": "207-903-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP241082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.