Jenifer L Madore, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP81462 Issued in ME

Practice address

100 Campus Ave
Suite 104
Lewiston, ME 04240-6040

Phone

(207) 777-4100

Fax

(207) 777-8994

NPI assigned

Oct 5, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Community Clinical Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Lewiston, ME
  • NPI 1629851761
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1356437453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1638",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122011638",
            "telephone_number": "207-777-4111",
            "fax_number": "207-783-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAMPUS AVE",
            "address_2": "SUITE 104",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406040",
            "telephone_number": "207-777-4100",
            "fax_number": "207-777-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADORE",
        "first_name": "JENIFER",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP81462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25878099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Macdonald-Webber, L.AC.
• Alyssa Joanna Macdonald, OTR/L
• Jenna Macdonald
• Amanda Leigh Mackellar, RN
• Elizabeth J Madore, DO
• Marc Madore, LCSW
• Normand Roger Madore, OD
• Teresita Maguire
• Marilyn Maher, LCSW; LACD
• Cynthia Marie Mailhot, LCSW

• Family Nurse Practitioner in Lewiston, ME
• Providers in Lewiston, 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 Mar 9, 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.