Active NPI
Crown Gastroenterology Associates
- Gastroenterology Physician
- Presque Isle, ME
National Provider Identifier
1477668390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- 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, 2009
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125140000ME | Medicaid | ME | |
| 007258 | Other | ME | ANTHEM |
| 1041858 | Other | ME | AETNA |
| 100009202 | Other | ME | RAILROAD MEDICARE |
| 2204280 | Other | ME | CIGNA |
National Provider Directory
National Provider DirectoryNPI 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.