Active NPI
Judith Chamberlain, MD
- Family Medicine Physician
- Brunswick, ME
National Provider Identifier
1386668432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 009810
- Practice address
- 74 Baribeau Dr
Brunswick, ME 04011-3218 - Phone
- (207) 798-4050
- Fax
- (207) 798-4018
- NPI assigned
- Jul 26, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 009810 | ME | Primary |
Addresses
Primary practice location
74 Baribeau Dr
Brunswick, ME 04011-3218
Mailing address
174 S Freeport Rd
Freeport, ME 04032-6145
Phone (207) 865-1819
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 026424 | Other | ME | ANTHEM |
| 1386668432 | Other | ME | TRICARE |
| 4636282 | Other | ME | AETNA |
| D03590 | Other | ME | HARVARD PILGRIM |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009810 | ME | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184284800000",
"number": "1386668432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "174 S FREEPORT RD",
"city": "FREEPORT",
"state": "ME",
"postal_code": "040326145",
"telephone_number": "207-865-1819",
"fax_number": "207-865-4535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "74 BARIBEAU DR",
"city": "BRUNSWICK",
"state": "ME",
"postal_code": "040113218",
"telephone_number": "207-798-4050",
"fax_number": "207-798-4018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMBERLAIN",
"first_name": "JUDITH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ME",
"license": "009810",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "026424",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "1386668432",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4636282",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "D03590",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brunswick, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.