Destry Oldham-Sibley, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP131060 Issued in ME

Practice address

66 Stone St
Augusta, ME 04330-5227

Phone

(207) 626-3455

Fax

(207) 626-7586

NPI assigned

Apr 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1407977374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 STONE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305227",
            "telephone_number": "207-626-3455",
            "fax_number": "207-626-7586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 STONE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305227",
            "telephone_number": "207-626-3455",
            "fax_number": "207-626-7586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDHAM-SIBLEY",
        "first_name": "DESTRY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC2710",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP131060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Occupational Health Centers of the Southwest, P.a.
• Grace Odimayo, DMD
• Barbara Elizabeth Oesterlin, DMD
• Chidiebere Ogbuta
• Ogheneochuko Gregory Okenabirhie
• Tammy Ellen Olsen, COTA/L
• William Theodore Olsen III, MD
• John Joseph Oprendek Jr., M.D.
• Celia Orff, LCSW
• William Otero Flores, PH.D.

• Psychiatric/Mental Health Nurse Practitioner in Augusta, ME
• Providers in Augusta, ME by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; 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.