NPIMap

Organization Active NPI

Massabesic Regional Medical Center

  • Family Medicine Physician
  • Waterboro, ME
National Provider Identifier
1386731552
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MASSABESIC REGIONAL MEDICAL CENTER
Practice address
813 Main Street
Waterboro, ME 04027
Phone
(207) 247-6131
Fax
(207) 247-6675
NPI assigned
Oct 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Gail M Wallingford
Title
Nurse/Billing/Insurance Provider
Phone
(207) 247-6131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

813 Main Street
Waterboro, ME 04027

Mailing address

813 Main Street
Massabesic Regional Medical Center
Waterboro, ME 04027
Phone (207) 247-6131

Other identifiers 2

IdentifierTypeStateIssuer
097204OtherMEAETNA
000973OtherMEANTHEM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386731552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 MAIN STREET",
            "address_2": "MASSABESIC REGIONAL MEDICAL CENTER",
            "city": "WATERBORO",
            "state": "ME",
            "postal_code": "04027",
            "telephone_number": "207-247-6131",
            "fax_number": "207-247-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 MAIN STREET",
            "city": "WATERBORO",
            "state": "ME",
            "postal_code": "04027",
            "telephone_number": "207-247-6131",
            "fax_number": "207-247-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSABESIC REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLINGFORD",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "NURSE/BILLING/INSURANCE PROVIDER",
        "authorized_official_telephone_number": "207-247-6131",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "097204",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000973",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterboro, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.