Active NPI
Bruce Packard, D.C.
- Chiropractor
- Bangor, ME
National Provider Identifier
1407884570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CR962
- Practice address
- 263 State St Ste 7
Bangor, ME 04401-5436 - Phone
- (207) 825-8809
- NPI assigned
- Jun 29, 2006
- Last updated
- Aug 16, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CR962 | ME | Primary |
Addresses
Primary practice location
263 State St Ste 7
Bangor, ME 04401-5436
Mailing address
500 River Rd
Orrington, ME 04474-3410
Phone (207) 825-8809
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CR962 | ME | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345075200000",
"number": "1407884570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 RIVER RD",
"city": "ORRINGTON",
"state": "ME",
"postal_code": "044743410",
"telephone_number": "207-825-8809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 STATE ST STE 7",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015436",
"telephone_number": "207-825-8809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACKARD",
"first_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2012-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ME",
"license": "CR962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.