Peregrine Corporation

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

PEREGRINE CORPORATION

Practice address

1011 Forest Avenue
Portland, ME 04103

Phone

(207) 879-0847

Fax

(207) 857-2919

NPI assigned

Dec 26, 2006

Organization subpart

No

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

Authorized official

Name

Carol A. Papciak

Title

Financial Manager

Phone

(207) 879-0847

Specialties & licenses 2

Addresses

Other identifiers 8

Other names 1

• Project for Supported Living Other name

Locations

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1497810964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 FOREST AVENUE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04103",
            "telephone_number": "207-879-0847",
            "fax_number": "207-857-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 FOREST AVENUE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04103",
            "telephone_number": "207-879-0847",
            "fax_number": "207-857-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEREGRINE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "PAPCIAK",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "207-879-0847"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124470100",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124470000",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124470300",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124470500",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124470001",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124470401",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124470402",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124470400",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Project for Supported Living",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicholas D Pennell, FNP
• Keating W Pepper, DO
• Paloma Alejandra Peraza
• Gregory Benjamin Perchik, LCSW
• Tessa Simone Peredy, DO
• Yara Perez, LCPC
• Max Perilstein
• Periodontal Associates
• Pamela Perkins, RD
• Sasha Syreeta Perkins, LCSW

• Case Management Agency in Portland, ME
• Providers in Portland, ME by specialty
• Case Management Agency in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.