NPIMap

Organization Active NPI

Centreboard 207 LLC

  • Physical Therapist
  • Yarmouth, ME
National Provider Identifier
1457082968
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CENTREBOARD 207 LLC
Practice address
350A Route 1
Ste 1B
Yarmouth, ME 04096
Phone
(207) 370-7118
NPI assigned
Jun 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Dr. Michelle Roy, DPTNPI 1649512666
Title
Physical Therapist/Owner
Phone
(207) 370-7118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

350A Route 1
Ste 1B
Yarmouth, ME 04096

Mailing address

350A Route 1
Ste 1B
Yarmouth, ME 04096
Phone (207) 370-7118

Other practice location 1

585 Walnut Hill Rd # B
North Yarmouth, ME 04097-6301
Phone (207) 370-7118

Other names 2

  • Centreboard Physical Therapy and Massage Doing business as
  • Centreboard Physiotherapy and Massage Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240102000492 ME Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7315397429 Receives reassigned benefits from 3 practitioners
Practice locations: North Yarmouth, ME

National Provider Directory

National Provider Directory

Locations

247 Portland St
Ste C
Yarmouth, ME 04096

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1457082968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350A ROUTE 1",
            "address_2": "STE 1B",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "04096",
            "telephone_number": "207-370-7118",
            "fax_number": "207-422-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350A ROUTE 1",
            "address_2": "STE 1B",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "04096",
            "telephone_number": "207-370-7118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "585 Walnut Hill Rd # B",
            "address_purpose": "LOCATION",
            "city": "North Yarmouth",
            "state": "ME",
            "postal_code": "040976301",
            "country_code": "US",
            "telephone_number": "207-370-7118",
            "fax_number": "207-422-7178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTREBOARD 207 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "ROY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "207-370-7118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centreboard Physical Therapy and Massage",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Centreboard Physiotherapy and Massage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yarmouth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.