Individual provider Active NPI

E. Terrance Smith

  • Developmentally Disabled Services Day Training Agency
  • Portland, ME
National Provider Identifier
1427286350
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Practice address
62 Melbourne Street
Portland, ME 04101-2727
Phone
(207) 318-5672
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

62 Melbourne Street
Portland, ME 04101-2727

Mailing address

62 Melbourne Street
Portland, ME 04101-2727
Phone (207) 318-5672

Other identifiers 1

IdentifierTypeStateIssuer
432750300MedicaidME

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1427286350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 MELBOURNE STREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012727",
            "telephone_number": "207-318-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 MELBOURNE STREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012727",
            "telephone_number": "207-318-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "E.",
        "middle_name": "TERRANCE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432750300",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.