Active NPI
Gregory Carbone, PH.D.
- Clinical Psychologist
- Portland, ME
National Provider Identifier
1326215864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS499
- Practice address
- 491 Stevens Ave
Portland, ME 04103-2636 - Phone
- (207) 828-4026
- Fax
- (207) 773-4472
- NPI assigned
- May 14, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS499 | ME | Primary |
Addresses
Primary practice location
491 Stevens Ave
Portland, ME 04103-2636
Mailing address
491 Stevens Ave
Portland, ME 04103-2636
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 314040099 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS499 | ME | MD | Clinical Psychologist |
Interoperability endpoints
- ccn.gregorycarbone@140126.advancedmd-direct.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210723200000",
"number": "1326215864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "491 STEVENS AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "491 STEVENS AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032636",
"telephone_number": "207-828-4026",
"fax_number": "207-773-4472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARBONE",
"first_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-14",
"last_updated": "2008-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "ME",
"license": "PS499",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "314040099",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.