Active NPI
Krystal Mecum, PHARMD
- Pharmacist
- Scarborough, ME
National Provider Identifier
1376972166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PR12950
- Practice address
- 417 Payne Rd
Scarborough, ME 04074-9594 - Phone
- (207) 510-3005
- Fax
- (207) 510-3012
- NPI assigned
- Nov 2, 2013
- Last updated
- Sep 20, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PR12950 | ME | Primary |
Addresses
Primary practice location
417 Payne Rd
Scarborough, ME 04074-9594
Mailing address
150 Western Ave
Augusta, ME 04330-7241
Other names 1
- Krystal Mecum
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PR12950 | ME | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shaws Supermarkets Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537401600000",
"number": "1376972166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 WESTERN AVE",
"city": "AUGUSTA",
"state": "ME",
"postal_code": "043307241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 PAYNE RD",
"city": "SCARBOROUGH",
"state": "ME",
"postal_code": "040749594",
"telephone_number": "207-510-3005",
"fax_number": "207-510-3012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MECUM",
"first_name": "KRYSTAL",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-02",
"last_updated": "2018-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ME",
"license": "PR12950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRYSTAL",
"last_name": "MECUM",
"credential": "PHARM.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Scarborough, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.