Freeport Place

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2103 Issued in ME

Legal business name

FREEPORT PLACE

Practice address

4 Old County Rd
Freeport, ME 04032-6231

Phone

(207) 865-3500

NPI assigned

Mar 25, 2009

Organization subpart

No

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

Authorized official

Name

Kenneth Bowden, CEO

Title

Ceo

Phone

(207) 874-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julia M Redding, DO

  • Geriatric Medicine (Family Medicine) Physician
  • Portland, ME
  • NPI 1932367034
  NPD (past)

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

CLIA laboratory certificates

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1497997233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 OLD COUNTY RD",
            "city": "FREEPORT",
            "state": "ME",
            "postal_code": "040326231",
            "telephone_number": "207-865-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 OLD COUNTY RD",
            "city": "FREEPORT",
            "state": "ME",
            "postal_code": "040326231",
            "telephone_number": "207-865-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEPORT PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-25",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "BOWDEN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-874-2700",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ME",
            "license": "2103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2103",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Freeport Dental Associates, P.C.
• Freeport Integrated Health Center, P.a.
• Freeport Medical Center PA
• Freeport Nursing Home, Inc
• Freeport Physical Therapy, PA
• Ann E Fullagar
• Lowell Ian Gerber, MD
• Daniel S Gibbons, DO
• Hadley Gibson, LMSW-CC
• Jacey E Goddard, DO

• All providers in Freeport, ME
• Assisted Living Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.