Individual provider Active NPI

Christopher L Nelson, PAC

  • Physician Assistant
  • Bangor, ME
National Provider Identifier
1477596880
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA691 Issued in ME
Practice address
360 Broadway
Bangor, ME 04401-3979
Phone
(207) 907-1770
Fax
(207) 907-3675
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 11

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.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.58 of 100Reported as apm
Quality
83.17
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.58 of 100Reported as apm
Quality
83.17
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20040928000651 ME Practitioner - Physician Assistant 1456320365 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1597WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Down East Community Hospital CurrentSince May 22, 2019 Accepting new patients
Mainehealth CurrentSince Feb 24, 2025 Accepting new patients
Mainehealth CurrentSince Jul 1, 2025 Accepting new patients
Eastern Maine Medical Center CurrentSince Jun 2, 2016 Accepting new patients
Mainehealth CurrentSince Jul 1, 2025 Accepting new patients
The Duluth Clinic, LTD. Past Accepting new patients
The Blue Hill Memorial Hospital Past Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients

Locations

489 State St
Bangor, ME 04401
Phone (207) 973-8837

116 Northport Ave
Ste 210
Belfast, ME 04915
Phone (207) 338-1838

11 Hospital Dr
Machias, ME 04654
Phone (207) 255-0434

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/6b68bc92-a317-4686-a79a-fbb1b58a509e/

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA691 ME Primary

Addresses

NPPES NPI Registry

Primary practice location

360 Broadway
Bangor, ME 04401-3979

Mailing address

C/O St Marys Health System - Provider Enrollment
PO Box 7291
Lewiston, ME 04243-7291
Phone (207) 777-8941

Other practice location 1

116 Northport Ave Ste 210
Belfast, ME 04915-6096
Phone (207) 505-4675

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
PA691OtherMESTATE LICENSE

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address cnelson1510570@direct-prd.goodhelpconnections.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 2, 2025.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1477596880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT",
            "address_2": "PO BOX 7291",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042437291",
            "telephone_number": "207-777-8941",
            "fax_number": "207-777-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013979",
            "telephone_number": "207-907-1770",
            "fax_number": "207-907-3675"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 Northport Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Belfast",
            "state": "ME",
            "postal_code": "049156096",
            "country_code": "US",
            "telephone_number": "207-505-4675",
            "fax_number": "207-338-3836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA691",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cnelson1510570@direct-prd.goodhelpconnections.org",
            "affiliation": "N",
            "address_1": "360 Broadway",
            "city": "Bangor",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044013979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.