Organization Active NPI

Midcoast Pediatrics

  • Pediatrics Physician
  • Brunswick, ME
National Provider Identifier
1346316791
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
012530 Issued in ME
Legal business name
MIDCOAST PEDIATRICS
Practice address
121 Medical Center Dr
Suite 2600
Brunswick, ME 04011-2653
Phone
(207) 721-8333
Fax
(207) 798-4618
NPI assigned
Nov 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
David L Enright, M.D.NPI 1528134822
Title
Ceo
Phone
(207) 721-8333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 012530 ME Primary

Addresses

Primary practice location

121 Medical Center Dr
Suite 2600
Brunswick, ME 04011-2653

Mailing address

121 Medical Center Dr
Suite 2600
Brunswick, ME 04011-2653
Phone (207) 721-8333

Other identifiers 1

IdentifierTypeStateIssuer
0019MOtherMEANTHEM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346316791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MEDICAL CENTER DR",
            "address_2": "SUITE 2600",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112653",
            "telephone_number": "207-721-8333",
            "fax_number": "207-798-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 MEDICAL CENTER DR",
            "address_2": "SUITE 2600",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112653",
            "telephone_number": "207-721-8333",
            "fax_number": "207-798-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDCOAST PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENRIGHT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-721-8333",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "012530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0019M",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.