Organization Active NPI

Merideth C Norris PA

  • Addiction Medicine (Family Medicine) Physician
  • Kennebunk, ME
National Provider Identifier
1376973651
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
ME1813 Issued in ME
Legal business name
MERIDETH C NORRIS PA
Practice address
58 Portland Rd
Suite 18
Kennebunk, ME 04043-6656
Phone
(207) 604-5034
NPI assigned
Nov 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Authorized official

Name
Merideth C Norris, DO
Title
Owner/Provider
Phone
(207) 604-5034

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 1813 ME
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X ME1813 ME Primary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X 1813 ME

Addresses

Primary practice location

58 Portland Rd
Suite 18
Kennebunk, ME 04043-6656

Mailing address

58 Portland Rd
Suite 18
Kennebunk, ME 04043-6656
Phone (207) 604-5034

Other identifiers 2

IdentifierTypeStateIssuer
280670099MedicaidME
E100136968OtherMEETAN

Other names 1

  • GRACEFUL RECOVERY Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426464000000",
    "number": "1376973651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 PORTLAND RD",
            "address_2": "SUITE 18",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436656",
            "telephone_number": "207-604-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 PORTLAND RD",
            "address_2": "SUITE 18",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436656",
            "telephone_number": "207-604-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDETH C NORRIS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2015-03-16",
        "status": "A",
        "authorized_official_last_name": "NORRIS",
        "authorized_official_first_name": "MERIDETH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "207-604-5034",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1813",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "ME",
            "license": "ME1813",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "ME",
            "license": "1813",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280670099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ETAN",
            "identifier": "E100136968",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRACEFUL RECOVERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennebunk, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.