Sally S Stothoff, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP81238 Issued in ME

Practice address

180 Kennedy Memorial Dr
Suite 204
Waterville, ME 04901-4540

Phone

(207) 872-5529

Fax

(207) 872-9219

NPI assigned

Sep 29, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1366439929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 KENNEDY MEMORIAL DR",
            "address_2": "SUITE 204",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014540",
            "telephone_number": "207-872-5529",
            "fax_number": "207-872-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 KENNEDY MEMORIAL DR",
            "address_2": "SUITE 204",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014540",
            "telephone_number": "207-872-5529",
            "fax_number": "207-872-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOTHOFF",
        "first_name": "SALLY",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "R024050",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP81238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "284350099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00066199",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "040915",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCA",
            "identifier": "AA21889",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan M. Stevens, D.O.
• Cameron Stewart
• Dale Stewart
• Isaac Matthew Stone, RN
• Jeffrey A Stone, D.O.
• Eric Straniero, P.T., D.P.T.
• Lauren Struck
• Jessica Elizabeth Sullivan
• Sunset Home of Waterville
• Mark Erin Sutherland, DO

• Family Nurse Practitioner in Waterville, ME
• Providers in Waterville, 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 May 23, 2016; 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.