NPIMap

Individual provider Active NPI

Deborah K Dumoulin, R.D., L.D.,

  • Registered Dietitian
  • Portland, ME
National Provider Identifier
1497969380
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DI217 Issued in ME
Practice address
MMC Bariatric Surgery Program
12 Andover Road
Portland, ME 04102
Phone
(207) 761-5612
NPI assigned
May 9, 2007
Last updated
Jun 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DI217 ME Primary

Addresses

Primary practice location

MMC Bariatric Surgery Program
12 Andover Road
Portland, ME 04102

Mailing address

5 Cliff LN
Biddeford, ME 04005-9382
Phone (207) 283-8074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth Past Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients
SMMC Visiting Nurses Past Accepting new patients
Mainehealth Care at Home PastSince Jan 20, 2016 Accepting new patients
Mainehealth Care at Home PastSince May 7, 2023 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients
SMMC Visiting Nurses Past Accepting new patients
Convenientmd LLC Past Accepting new patients

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1497969380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CLIFF LN",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059382",
            "telephone_number": "207-283-8074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC BARIATRIC SURGERY PROGRAM",
            "address_2": "12 ANDOVER ROAD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-761-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMOULIN",
        "first_name": "DEBORAH",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "R.D., L.D.,",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ME",
            "license": "DI217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.