Pediatric Cardiology Assoc PA

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

014324 Issued in ME

Legal business name

PEDIATRIC CARDIOLOGY ASSOC PA

Doing business as

CONGENITAL HEART

Practice address

71 US Route 1
Suite C
Scarborough, ME 04074-7173

Phone

(207) 883-5532

Fax

(207) 883-5552

NPI assigned

Nov 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jon Patrick Donnelly, MD

Title

President

Phone

(207) 883-5532

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• CONGENITAL HEART Doing business as

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503878400000",
    "number": "1346311925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 US ROUTE 1",
            "address_2": "SUITE C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747173",
            "telephone_number": "207-883-5532",
            "fax_number": "207-883-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 US ROUTE 1",
            "address_2": "SUITE C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747173",
            "telephone_number": "207-883-5532",
            "fax_number": "207-883-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARDIOLOGY ASSOC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2017-08-28",
        "status": "A",
        "authorized_official_last_name": "DONNELLY",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-883-5532",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "ME",
            "license": "014324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112590000",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30004962",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONGENITAL HEART",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Henry Roy Partridge, MSW, PH.D.
• Pathways of Maine, Inc.
• Nicole Ann Patterson, FNP-BC
• Eric Payeur, PHARMD
• Samantha Pease, MS, NTP, RWP
• Pediatric Dentistry Asleep of Maine
• Michelle Pelchat, DPT
• Diane Naomi Pelletier, LCSW
• Sarah Drosdik Pelletier, NP
• Joseph Guy Penna, DMD

• Pediatric Cardiology Physician in Scarborough, ME
• Providers in Scarborough, ME by specialty
• Pediatric Cardiology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.