Active NPI
Lawrence R Ricci, MD
- Pediatrics Physician
- Portland, ME
National Provider Identifier
1386713634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 10718
- Practice address
- 17 Bishop St
Portland, ME 04103-2659 - Phone
- (207) 871-1235
- Fax
- (207) 871-6161
- NPI assigned
- Nov 8, 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 10718 | ME | Primary |
Addresses
Primary practice location
17 Bishop St
Portland, ME 04103-2659
Mailing address
899 Riverside St
Portland, ME 04103-1070
Phone (207) 871-1200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30788099 | Medicaid | ME | |
| RB7 | Other | ME | ANTHEM |
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 |
|---|---|---|---|
| 10718 | ME | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1386713634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "899 RIVERSIDE ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041031070",
"telephone_number": "207-871-1200",
"fax_number": "207-871-1232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 BISHOP ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032659",
"telephone_number": "207-871-1235",
"fax_number": "207-871-6161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICCI",
"first_name": "LAWRENCE",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "ME",
"license": "10718",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30788099",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "RB7",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.