Thomas J Vanidestine Jr

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

THOMAS J VANIDESTINE JR

Practice address

336 Mount Hope Ave
Suite 11
Bangor, ME 04401-4236

Phone

(207) 942-2800

Fax

(207) 990-2362

NPI assigned

May 25, 2006

Last updated

Mar 16, 2017By 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

Thomas J Vanidestine Jr., DCNPI 1538108022

Title

Owner

Phone

(207) 942-2800

Specialties & licenses 1

Addresses

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas J Vanidestine Jr., DC, CCSP

  • Chiropractor
  • Bangor, ME
  • NPI 1538108022
  Authorized official Same address or phone
• Patricia L Cline, DC

  • Chiropractor
  • Bangor, ME
  • NPI 1053353482
  NPD (past)
• Michael Gilmore, DO

  • Family Medicine Physician
  • Bangor, ME
  • NPI 1053336206
  NPD (past)
• Thomas Joseph Boutaugh, MSPT

  • Physical Therapist
  • Stevens, PA
  • NPI 1811955115
  NPD (past)
• Lewis A. Hassell, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Oklahoma City, OK
  • NPI 1831115120
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1487600011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 MOUNT HOPE AVE",
            "address_2": "SUITE 11",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014236",
            "telephone_number": "207-942-2800",
            "fax_number": "207-990-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 MOUNT HOPE AVE",
            "address_2": "SUITE 11",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014236",
            "telephone_number": "207-942-2800",
            "fax_number": "207-990-2362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J VANIDESTINE JR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "VANIDESTINE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-942-2800",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Thibault, L.AC
• Jayne Elizabeth Gilbert Thibodeau, M.ED.
• Noel Edward Thibodeau
• Sheila Thibodeau, LCSW, CCS
• Kaylin Thies, DMD
• Amanda Thomas, LCPC
• Christina Lee Thomas, CNA
• James Thomas, PH.D.
• Lindy May Thomas, PHYSICIAN ASSISTANT
• Scott A Thomas, D.O.

• Chiropractor in Bangor, ME
• Providers in Bangor, ME by specialty
• Chiropractor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.