Individual provider Active NPI

Gayle E Myers, MSN ANP

  • Adult Health Nurse Practitioner
  • South Portland, ME
National Provider Identifier
1447220728
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
CNP81087 Issued in ME
Practice address
169 Ocean St Ste 104
South Portland, ME 04106-3636
Phone
(207) 712-6068
Fax
(207) 747-4424
NPI assigned
Jan 26, 2006
Last updated
Jan 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X CNP81087 ME Primary

Addresses

Primary practice location

169 Ocean St Ste 104
South Portland, ME 04106-3636

Mailing address

301 US Route 1
Scarborough, ME 04074-7609
Phone (207) 396-8600

Other identifiers 3

IdentifierTypeStateIssuer
432313599MedicaidME
30344481MedicaidME
30344481MedicaidNH

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
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP81087MEMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gem Health & Wellness Current Accepting new patients
Gem Healthcare Services Past Accepting new patients
Southern Maine Geriatrics Associates LLC Adult Health Past Accepting new patients
Max Health Maine LLC Past Accepting new patients

Locations

169 Ocean St
Ste 104
South Portland, ME 04106
Phone (207) 712-6068

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/4083/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1447220728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747609",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 OCEAN ST STE 104",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063636",
            "telephone_number": "207-712-6068",
            "fax_number": "207-747-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "GAYLE",
        "middle_name": "E",
        "credential": "MSN ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ME",
            "license": "CNP81087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432313599",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30344481",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30344481",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.