Katahdin Nursing Home

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

36319 Issued in ME

Legal business name

KATAHDIN NURSING HOME

Practice address

22 Walnut St
Millinocket, ME 04462-2128

Phone

(207) 723-4711

Fax

(207) 723-6704

NPI assigned

Oct 17, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Marlene E. Campbell, ADMIN.

Title

Adminstrator

Phone

(207) 723-4711

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366431033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 WALNUT ST",
            "city": "MILLINOCKET",
            "state": "ME",
            "postal_code": "044622128",
            "telephone_number": "207-723-4711",
            "fax_number": "207-723-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 WALNUT ST",
            "city": "MILLINOCKET",
            "state": "ME",
            "postal_code": "044622128",
            "telephone_number": "207-723-4711",
            "fax_number": "207-723-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATAHDIN NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "207-723-4711",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ADMIN."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "ME",
            "license": "36319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David P Johnson, PA
• Josh H Jones, RN
• Thomas Edward Jones II, MOTR/L
• Katahdin Friends, Inc.
• Katahdin Health Care LLC
• Katahdin Valley Health Center
• Katahdin Valley Health Center
• Garbis D Keusseyan
• Micheal S Kight, LMT
• Sandra J Kimball, RAD

• Nursing Facility/Intermediate Care Facility in Millinocket, ME
• Providers in Millinocket, ME by specialty
• Nursing Facility/Intermediate Care Facility in Maine

• 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.