Active NPI
Gordon Thompson Caldwell Jr., MD
- Pain Medicine Physician
- Lewiston, ME
National Provider Identifier
1376510057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- 012721
- Practice address
- 77 Bates St
Suite 102
Lewiston, ME 04240-7637 - Phone
- (207) 783-2300
- Fax
- (207) 783-2439
- NPI assigned
- Mar 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine Physician | 208VP0000X | 012721 | ME | Primary |
Addresses
Primary practice location
77 Bates St
Suite 102
Lewiston, ME 04240-7637
Mailing address
77 Bates St
Suite 102
Lewiston, ME 04240-7637
Phone (207) 783-2300
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030495 | Other | BCBS | |
| 010424957 | Other | CHAMPUS | |
| M52001 | Other | CIGNA | |
| E19633 | Other | HARVARD PILGRIM | |
| 010424957 | Other | EMPLOY STANDARDS | |
| 010424957 | Other | TRICARE | |
| 2075723 | Other | AETNA | |
| 25012128 | Other | MEDICARE RAILROAD | |
| 272410099 | Medicaid | ME | |
| 010424957 | Other | STANDARD TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012721 | ME | MD | Pain Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303948800000",
"number": "1376510057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 BATES ST",
"address_2": "SUITE 102",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042407637",
"telephone_number": "207-783-2300",
"fax_number": "207-783-2439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 BATES ST",
"address_2": "SUITE 102",
"city": "LEWISTON",
"state": "ME",
"postal_code": "042407637",
"telephone_number": "207-783-2300",
"fax_number": "207-783-2439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDWELL",
"first_name": "GORDON",
"middle_name": "THOMPSON",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-02",
"last_updated": "2011-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "ME",
"license": "012721",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "030495",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "010424957",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "M52001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "E19633",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPLOY STANDARDS",
"identifier": "010424957",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "010424957",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "2075723",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "25012128",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "272410099",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STANDARD TAX ID",
"identifier": "010424957",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewiston, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.