Organization Active NPI

Lakewood

Doing business as Northern Light Continuing Care, Lakewood

  • Skilled Nursing Facility
  • Waterville, ME
National Provider Identifier
1336238039
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
36552 Issued in ME
Legal business name
LAKEWOOD
Doing business as
Northern Light Continuing Care, Lakewood
Practice address
220 Kennedy Memorial Dr
Waterville, ME 04901-4526
Phone
(207) 873-5125
Fax
(207) 861-9967
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Authorized official

Name
Patricia R Bird
Title
Business Office Manager
Phone
(207) 873-5125

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 36552 ME
Skilled Nursing Facility 314000000X 36552 ME Primary

Addresses

Primary practice location

220 Kennedy Memorial Dr
Waterville, ME 04901-4526

Mailing address

220 Kennedy Memorial Dr
Waterville, ME 04901-4526
Phone (207) 873-5125

Other identifiers 1

IdentifierTypeStateIssuer
117430000MedicaidME

Other names 1

  • Northern Light Continuing Care, Lakewood Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150213001027 ME Part A Provider - Skilled Nursing Facility 7315262359 Practice locations: Waterville, ME

Skilled nursing facility certification: CCN 205138

Legal name
EASTERN MAINE HEALTHCARE SYSTEMS
Doing business as
LAKEWOOD A CONTINUING CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1993
Last certification
Nov 14, 2024
Beds
105
Ownership / control type
Limited Liability Corporation
Multi-facility organization
First Atlantic HealthCare
Organization structure
CorporationNon-profit
Incorporated
Jan 6, 1983 in ME
Enrollment address
220 Kennedy Memorial Dr
Waterville, ME 04901-4526
Nursing home name
LAKEWOOD A CONTINUING CARE CENTER

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lakewood A Continuing Care CenterCCN 205138 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10592.8 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0670648Northern Light Lakewood, a Continuing Care Center220 Kennedy Memorial Drive, Waterville, ME 04901Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

220 Kennedy Memorial Dr
Waterville, ME 04901
Phone (207) 873-2823

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Chris Gaunce Individual Corporate DirectorLakewood Director Jan 24, 2013
John E Marden Individual Corporate DirectorLakewood Director Jan 25, 2018
Bryan B. Ward Individual Operational/Managerial ControlBoard Member Nov 1, 2014
Crystal a. Olsen Individual Operational/Managerial ControlBoard Member Mar 1, 2011
Randall L. Clark Individual Corporate DirectorAssistant Treasurer Sep 3, 2021
Operational/Managerial ControlVice President of Finances Sep 3, 2021

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1336238039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014526",
            "telephone_number": "207-873-5125",
            "fax_number": "207-861-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014526",
            "telephone_number": "207-873-5125",
            "fax_number": "207-861-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A",
        "authorized_official_last_name": "BIRD",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "207-873-5125"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "ME",
            "license": "36552",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ME",
            "license": "36552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117430000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Light Continuing Care, Lakewood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterville, ME

Sources for this page

Verify at the official NPI Registry.