Radiance Facial Cosmetic Surgery & Laser Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

36809 Issued in ME

Legal business name

RADIANCE FACIAL COSMETIC SURGERY & LASER CENTER

Practice address

181 Academy St
Suite #1
Presque Isle, ME 04769-3178

Phone

(207) 764-6337

Fax

(207) 764-1446

NPI assigned

Jun 24, 2008

Last updated

Sep 10, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Debbie L Rooney

Title

Office Manager

Phone

(207) 764-6337

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221004800000",
    "number": "1467613299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 ACADEMY ST",
            "address_2": "SUITE #1",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693178",
            "telephone_number": "207-764-6337",
            "fax_number": "207-764-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 ACADEMY ST",
            "address_2": "SUITE #1",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693178",
            "telephone_number": "207-764-6337",
            "fax_number": "207-764-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANCE FACIAL COSMETIC SURGERY & LASER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2008-09-10",
        "status": "A",
        "authorized_official_last_name": "ROONEY",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "207-764-6337",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "ME",
            "license": "36809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132730000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Renee Jamerson Pressley, DNP, APRN, PMHNP-BC
• Frances Prest, MHRT-CSP
• Sheelagh Prosser, MD
• Amber Dawn Pulcifur, CAC7967
• Ashley A Putnam Cole, OQMHP-COMMUNITY
• Christopher S. Ramsey, MHRT-CSP
• Jennifer Rancourt, BSW
• Kathryn Raymond, FNP-C
• Kristie Raymond, MHRT CSP
• Brydan David Regehr, D.D.S.

• Ambulatory Surgical Clinic/Center in Presque Isle, ME
• Providers in Presque Isle, ME by specialty
• Ambulatory Surgical Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.