Organization Active NPI

Crown Gastroenterology Associates

  • Gastroenterology Physician
  • Presque Isle, ME
National Provider Identifier
1477668390
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
CROWN GASTROENTEROLOGY ASSOCIATES
Practice address
11 Martin St
Presque Isle, ME 04769-2238
Phone
(207) 764-0679
Fax
(207) 764-1569
NPI assigned
Aug 20, 2006
Last updated
Jun 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Authorized official

Name
William Silber
Title
President
Phone
(207) 764-0679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

11 Martin St
Presque Isle, ME 04769-2238

Mailing address

11 Martin St
Presque Isle, ME 04769-2238
Phone (207) 764-0679

Other identifiers 5

IdentifierTypeStateIssuer
125140000MEMedicaidME
007258OtherMEANTHEM
1041858OtherMEAETNA
100009202OtherMERAILROAD MEDICARE
2204280OtherMECIGNA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244592000000",
    "number": "1477668390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MARTIN ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047692238",
            "telephone_number": "207-764-0679",
            "fax_number": "207-764-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MARTIN ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047692238",
            "telephone_number": "207-764-0679",
            "fax_number": "207-764-1569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN GASTROENTEROLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2009-06-10",
        "status": "A",
        "authorized_official_last_name": "SILBER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-764-0679"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125140000ME",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "007258",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1041858",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100009202",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2204280",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Presque Isle, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.