NPIMap

Organization Active NPI

Calais Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Calais, ME
National Provider Identifier
1376546143
Registry record updated Jul 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
36210 Issued in ME
Legal business name
CALAIS COMMUNITY HOSPITAL
Practice address
24 Hospital LN
Calais, ME 04619-1329
Phone
(207) 454-7521
Fax
(207) 454-3616
NPI assigned
May 24, 2005
Last updated
Jul 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2021

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

Authorized official

Name
Lynnette Parr
Title
Cfo
Phone
(207) 255-0269

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 36210 ME Primary

Addresses

Primary practice location

24 Hospital LN
Calais, ME 04619-1329

Mailing address

24 Hospital LN
Calais, ME 04619-1329
Phone (207) 454-7521

Other identifiers 6

IdentifierTypeStateIssuer
101960100MedicaidME
000008OtherMEANTHEM BLUE CROSS
010211783OtherMETRICARE
900800OtherMEHARVARD PILGRIM
0439887OtherMECIGNA
0012304OtherMEAETNA

Other names 1

  • CALAIS COMMUNITY SWING BEDS Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210729003060 ME Part A Provider - Critical Access Hospital 0345649158 Practice locations: Calais, ME
O20210910001201 ME Part B Supplier - Hospital Department(S) 0345649158 Receives reassigned benefits from 91 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Calais, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376546143. Details of each certification follow.

Hospital certification: CCN 20Z305

Legal name
CALAIS COMMUNITY HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Mar 3, 2021 in ME
Enrollment address
24 Hospital LN
Calais, ME 46191329
Hospital Swing-Bed Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Calais Community Hospital4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15 Palmer St
Calais, ME 04619
Phone (207) 454-7361

22 Hospital Ln
Calais, ME 04619

417 Main St
Uppr
Calais, ME 04619
Phone (207) 454-8432

43 Palmer St
Calais, ME 04619
Phone (207) 454-7200

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Wayne a Peters Individual Corporate DirectorBoard Memeber Mar 3, 2021
Michael E Hennessey Individual Corporate OfficerBoard Treasurer Mar 3, 2021
Kathryn M Land Individual Corporate OfficerBoard Chairman Mar 3, 2021
Eric M Burke Individual Corporate DirectorBoard Member Mar 3, 2021
Lisa M Carlisle Individual Corporate OfficerBoard Vice Chairman Mar 3, 2021
Usda Department of Agriculture Rural Development Organization, Bangor, ME Created for acquisition, Corporation 5% Or Greater Mortgage Interest Jul 1, 2021 100%
John M Corrigan Individual Corporate DirectorBoard Member Mar 3, 2021
Lynnette Parr Individual Corporate OfficerCfo Mar 3, 2021
Rita F Ten Individual Corporate Director Mar 3, 2021
Steve L Lail Individual Corporate OfficerCeo Mar 3, 2021
Karen Eldrigde Individual Corporate DirectorBoard Member Mar 3, 2021
Down East Community Hospital Organization, Machias, ME Corporation, Non-profit Other Jul 1, 2021
Genevieve Westhaver Individual W-2 Managing EmployeeDirector of Nursing May 1, 2021
Jacqueline M O'Clair Individual Corporate DirectorBoard Memeber Mar 3, 2021
Rose M St. Louis Individual Corporate DirectorBoard Member Mar 3, 2021
Corey K Schwinn Individual Corporate DirectorBoard Member Mar 3, 2021
Betty J Marshall Individual Corporate DirectorBoard Member Mar 3, 2021
Christian I Inegbeniji Individual Corporate DirectorBoard Member Mar 3, 2021
Nate J Martell Individual Corporate OfficerBoard Memeber Secretary Mar 3, 2021

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 62

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.

View all 62

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627603200000",
    "number": "1376546143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL LN",
            "city": "CALAIS",
            "state": "ME",
            "postal_code": "046191329",
            "telephone_number": "207-454-7521",
            "fax_number": "207-454-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HOSPITAL LN",
            "city": "CALAIS",
            "state": "ME",
            "postal_code": "046191329",
            "telephone_number": "207-454-7521",
            "fax_number": "207-454-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALAIS COMMUNITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A",
        "authorized_official_last_name": "PARR",
        "authorized_official_first_name": "LYNNETTE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "207-255-0269"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "ME",
            "license": "36210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101960100",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000008",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "010211783",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "900800",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0439887",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0012304",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CALAIS COMMUNITY SWING BEDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Calais, ME

Sources for this page

Verify at the official NPI Registry.