Donna Maria Bordeaux

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT651 Issued in ME

Practice address

22 Lincoln Street
Brunswick, ME 04011

Phone

(207) 729-1164

Fax

(207) 725-0905

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Donna Dutton Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1386737872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 LINCOLN STREET",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "04011",
            "telephone_number": "207-729-1164",
            "fax_number": "207-725-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 LINCOLN STREET",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "04011",
            "telephone_number": "207-729-1164",
            "fax_number": "207-725-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDEAUX",
        "first_name": "DONNA",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122120099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "DUTTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bluewater Emergency Partners of Brunswick, LLC
• Bluewater Emergency Partners of Calais, LLC Dba: Bluewater Urgent Care
• Bluewater Health of Vermont, LLC
• Eileen M. Boardman, LCSW
• Katelyn A Bolduc, FNP
• Amy B Bosinske, PA C
• Lawrence David Bossong, DDS
• Lilia Bottino, LMSW-CC
• Gerard P. Bouchard, RPH
• Christiana Boucher

• Physical Therapist in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; 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.