Janis Bacon Petzel, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

015653 Issued in ME

Practice address

116 Second St
Suite 1
Hallowell, ME 04347-1331

Phone

(207) 242-4007

NPI assigned

Jul 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: jpetzel738674@wm.providencedirect.org

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.

• Protea Behavioral Health Services

  • Public Health or Welfare Agency
  • Bangor, ME
  • NPI 1700814712
  NPD (past)
• Sweetser

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saco, ME
  • NPI 1538122445
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1477571362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SECOND ST",
            "city": "HALLOWELL",
            "state": "ME",
            "postal_code": "043471130",
            "telephone_number": "207-242-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 SECOND ST",
            "address_2": "SUITE 1",
            "city": "HALLOWELL",
            "state": "ME",
            "postal_code": "043471331",
            "telephone_number": "207-242-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETZEL",
        "first_name": "JANIS",
        "middle_name": "BACON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "015653",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "ME",
            "license": "015653",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD60650723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louise R Ouellette, LCPC
• Cher A Parmenter, C.O.T.A./L
• Pathways of Maine, Inc.
• Addie Pelletier, M.A., CF-SLP
• Jennifer Perry, LSW
• Patricia Sullivan Philbrook, N.P.
• Courtney Phillips
• Kevin Lee Polk, PH.D.
• Christopher Isaiah Pomerleau, DPT, PT
• Protea Integrated Health and Wellness, LLC

• Psychiatry Physician in Hallowell, ME
• Providers in Hallowell, ME by specialty
• Psychiatry Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.