Peter R Shumway, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3692 Issued in ME

Practice address

281 Western Ave
Augusta, ME 04330-4933

Phone

(207) 622-0861

Fax

(207) 626-3146

NPI assigned

Jun 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Evergreen Dental Associates LLC

  • General Practice Dentistry
  • Augusta, ME
  • NPI 1013121342
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306881511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 WESTERN AVE",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043304933",
            "telephone_number": "207-622-0861",
            "fax_number": "207-626-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "281 WESTERN AVE",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043304933",
            "telephone_number": "207-622-0861",
            "fax_number": "207-626-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUMWAY",
        "first_name": "PETER",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "3692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice May Shores, RPH
• Heather Marie Shorey, LCSW-CC
• Chelsea Victoria Short, LCSW
• Chayoung Shoulders, DO
• Daniel Jordan Shubert
• Marie Lyse Sicotte, FNP
• Sally Sidhom
• Charmaine Silveira Da Graca Costa
• Laura Gladstone Silver, DO
• Christian Blake Silverthorne, MM, LMSW-CC

• General Practice Dentistry in Augusta, ME
• Providers in Augusta, ME by specialty
• General Practice Dentistry in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.