NPIMap

Organization Active NPI

Southern Maine Geriatrics Associates LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Freeport, ME
National Provider Identifier
1366553091
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
SOUTHERN MAINE GERIATRICS ASSOCIATES LLC
Practice address
50 Marquis Rd
Freeport, ME 04032-6477
Phone
(207) 865-6131
Fax
(207) 865-9399
NPI assigned
Aug 31, 2006
Last updated
Sep 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Authorized official

Name
Michael J Bither, MDNPI 1437181872
Title
Owner
Phone
(207) 865-6131

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NU
Adult Health Nurse Practitioner 363LA2200X NU
Family Nurse Practitioner 363LF0000X NU
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary

Addresses

Primary practice location

50 Marquis Rd
Freeport, ME 04032-6477

Mailing address

50 Marquis Rd
Freeport, ME 04032-6477
Phone (207) 865-6131

Other identifiers 2

IdentifierTypeStateIssuer
134840000MedicaidME
30214096MedicaidNH

National Provider Directory

National Provider Directory

Locations

301C US Route 1
Scarborough, ME 04074
Phone (207) 396-8600

Practitioners & affiliated clinicians

Practitioners 11

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1366553091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MARQUIS RD",
            "city": "FREEPORT",
            "state": "ME",
            "postal_code": "040326477",
            "telephone_number": "207-865-6131",
            "fax_number": "207-865-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MARQUIS RD",
            "city": "FREEPORT",
            "state": "ME",
            "postal_code": "040326477",
            "telephone_number": "207-865-6131",
            "fax_number": "207-865-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MAINE GERIATRICS ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "BITHER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-865-6131",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134840000",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30214096",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeport, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.