Maryann W Waterman, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP081559 Issued in ME

Practice address

887 Congress St
Suite 320
Scarborough, ME 04102-3103

Phone

(207) 662-5522

Fax

(207) 662-5527

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Mainehealth

  • Family Medicine Physician
  • Portland, ME
  • NPI 1629761978
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1346352978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 US ROUTE 1",
            "address_2": "BUILDING C",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 CONGRESS ST",
            "address_2": "SUITE 320",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "041023103",
            "telephone_number": "207-662-5522",
            "fax_number": "207-662-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "MARYANN",
        "middle_name": "W",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "AP081559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30347697",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "281530099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew P Wallent, MPT
• Jennifer Waltz, PTA
• Lily Jinling Wang, MD
• Stacey Warren, OTR/L
• Stefanie Lynn Warren, FNP
• Virginia Coughlin Weill, SLP
• Aaron R Weiss, DO
• Tiffani Brooke Wenck, FNP
• Cheyne West
• Erica Wetmore, FNP

• Family Nurse Practitioner in Scarborough, ME
• Providers in Scarborough, ME by specialty
• Family Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; 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.