Individual provider Active NPI

Janice E. Dudley, PNP

  • Pediatric Nurse Practitioner
  • Portland, ME
National Provider Identifier
1427019694
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
CNP81681 Issued in ME
Practice address
22 Bramhall St
Portland, ME 04102-3134
Phone
(207) 662-2273
Fax
(207) 662-6324
NPI assigned
Mar 29, 2006
Last updated
Jan 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X CNP81681 ME Primary

Addresses

Primary practice location

22 Bramhall St
Portland, ME 04102-3134

Mailing address

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, DE2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060306000155 ME Practitioner - Nurse Practitioner 6507872298 Reassigns benefits to 4 organizations
I20240215000018 DE Practitioner - Nurse Practitioner 6507872298 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Sep 1, 2014 Accepting new patients
Maine Medical Partners CurrentSince Nov 13, 2017 Accepting new patients
Maine Medical Partners Pediatrics Current Accepting new patients
Maine Medical Partners Pediatrics CurrentSince Sep 1, 2014 Accepting new patients
Mainehealth CurrentSince Sep 1, 2014 Accepting new patients
Maine Medical Partners Current Accepting new patients
Maine Medical Partners CurrentSince Sep 1, 2014 Accepting new patients
The Nemours Foundation CurrentSince Jan 24, 2024 Accepting new patients
The Nemours Foundation CurrentSince Jan 24, 2024 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners Pediatrics CurrentSince Sep 1, 2014 Accepting new patients

Locations

1600 Rockland Rd
Wilmington, DE 19803

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

887 Congress St
Portland, ME 04102
Phone (207) 662-5522

887 Congress St
Ste 210
Portland, ME 04102
Phone (207) 774-2381

887 Congress St
Ste 300
Portland, ME 04102
Phone (207) 662-5555

887 Congress St
Ste 410A
Portland, ME 04102
Phone (207) 772-4444

301C US Route 1
Scarborough, ME 04074
Phone (207) 396-8600

49 Spring St
Scarborough, ME 04074
Phone (207) 883-1414

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: jdudley3054@direct.mmc.mainehealth.org

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1427019694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-2273",
            "fax_number": "207-662-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023134",
            "telephone_number": "207-662-2273",
            "fax_number": "207-662-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "JANICE",
        "middle_name": "E.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ME",
            "license": "CNP81681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.