Individual provider Active NPI

Kathleen A Pelkey, D.O.

  • Family Medicine Physician
  • Bar Harbor, ME
National Provider Identifier
1457322091
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1586 Issued in ME
Practice address
600 Main St
Bar Harbor, ME 04609-1523
Phone
(207) 288-6096
Fax
(207) 288-6443
NPI assigned
Jan 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1586 ME Primary

Addresses

Primary practice location

600 Main St
Bar Harbor, ME 04609-1523

Mailing address

PO Box 934
Bangor, ME 04402-0934
Phone (207) 907-3339

Other identifiers 1

IdentifierTypeStateIssuer
291130099MedicaidME

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1586MEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Desert Island Hospital PastSince Feb 9, 2020 Accepting new patients
Mount Desert Island Hospital Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/b5eba017-85d4-4b6c-a2f0-9b2c7b0c38dd/

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1457322091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 934",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044020934",
            "telephone_number": "207-907-3339",
            "fax_number": "207-907-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MAIN ST",
            "city": "BAR HARBOR",
            "state": "ME",
            "postal_code": "046091523",
            "telephone_number": "207-288-6096",
            "fax_number": "207-288-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELKEY",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291130099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bar Harbor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.