NPIMap

Organization Active NPI

Dexter Manor Associates

  • Skilled Nursing Facility
  • Dexter, ME
National Provider Identifier
1487640520
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
36625 Issued in ME
Legal business name
DEXTER MANOR ASSOCIATES
Practice address
64 Park St
Dexter, ME 04930-1470
Phone
(207) 924-5516
NPI assigned
Sep 23, 2005
Last updated
Feb 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Authorized official

Name
Kenneth W Bowden
Title
Ceo
Phone
(207) 874-2700

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 36344 ME
Occupational Medicine Clinic/Center 261QX0100X 36344 ME
Skilled Nursing Facility 314000000X 36625 ME Primary
Speech-Language Pathologist 235Z00000X 36344 ME

Addresses

Primary practice location

64 Park St
Dexter, ME 04930-1470

Mailing address

64 Park St
Dexter, ME 04930-1470
Phone (207) 924-5516

Other identifiers 1

IdentifierTypeStateIssuer
119080000MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030905000007 ME Part A Provider - Skilled Nursing Facility 8022929397 Practice locations: Dexter, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487640520. Details of each certification follow.

Skilled nursing facility certification: CCN 205115

Legal name
DEXTER MANOR ASSOCIATES
Doing business as
MAINE MEDICAL PARTNERS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1993
Last certification
Oct 31, 2024
Beds
53
Ownership / control type
Corporation
Multi-facility organization
First Atlantic Healthcare
Organization structure
PartnershipProprietary
Incorporated
Mar 29, 1988 in ME
Enrollment address
64 Park St
Dexter, ME 04930-1470
Nursing home name
DEXTER HEALTH CARE
Affiliated entity
FIRST ATLANTIC HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Dexter Health CareCCN 205115 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5343.8 residents per day on average
Chain
First Atlantic Healthcare10 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
1Fines totaling $10,033

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0090371Dexter Manor Assoc/Dexter Health Care64 Park Street, Dexter, ME 04930Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

64 Park St
Dexter, ME 04930
Phone (207) 924-5516

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tammy Jost Individual Operational/Managerial Control Feb 6, 2024
Adp of the SNF Feb 6, 2024
Craig G Coffin Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2019 66.67%
Trustee of the SNF Oct 1, 2024
Adp of the SNF Jun 30, 2019
Indirect Ownership Interest Jun 30, 2019 66.67%
Eastern Maine Medical Center Organization, Brewer, ME Corporation 5% Or Greater Direct Ownership Interest Oct 1, 2018 50%
Adp of the SNF Oct 1, 2018
Kenneth W Bowden Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2019 33.33%
Trustee of the SNF Oct 1, 2024
Adp of the SNF Jun 30, 2019
Indirect Ownership Interest Jun 30, 2019 33.33%
First Atlantic Healthcare Inc Organization, South Portland, ME Corporation, Chain home office Adp of the SNF Feb 21, 2025
Fred Fridman Individual Operational/Managerial Control Jul 11, 2024
Adp of the SNF Jul 11, 2024
Andrea Otis-Higgins Individual Corporate OfficerCoo May 11, 2015 100%
Operational/Managerial Control May 11, 2015
Adp of the SNF May 11, 2015
Maine Medical Consultants PC Organization, Portland, ME Operational/Managerial Control Jul 11, 2024
Adp of the SNF Feb 19, 2025
First Atlantic Corporation Organization, South Portland, ME Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 29, 1988 50%
Operational/Managerial Control Mar 29, 1988
Adp of the SNF Mar 29, 1988
Wanda Pelkey Individual Corporate OfficerCeo Oct 1, 2024 100%
Operational/Managerial Control Oct 1, 2024
Adp of the SNF Oct 1, 2024

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519776000000",
    "number": "1487640520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 PARK ST",
            "city": "DEXTER",
            "state": "ME",
            "postal_code": "049301470",
            "telephone_number": "207-924-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 PARK ST",
            "city": "DEXTER",
            "state": "ME",
            "postal_code": "049301470",
            "telephone_number": "207-924-5516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEXTER MANOR ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-23",
        "last_updated": "2018-02-28",
        "status": "A",
        "authorized_official_last_name": "BOWDEN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-874-2700"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ME",
            "license": "36344",
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "ME",
            "license": "36344",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ME",
            "license": "36625",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "36344",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119080000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dexter, ME

Sources for this page

Verify at the official NPI Registry.