Northbridge Avita Brunswick II LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

NORTHBRIDGE AVITA BRUNSWICK II LLC

Practice address

89 Admiral Fitch Ave
Brunswick, ME 04011-2700

Phone

(207) 729-0222

Fax

(207) 729-0222

NPI assigned

Mar 1, 2019

Organization subpart

Yes

Parent organization

NORTHBRIDGE AVITA BRUNSWICK II LLCAs reported in NPPES

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

Authorized official

Name

Wendy Nowokunski

Title

President

Phone

(781) 238-4856

Specialties & licenses 1

Addresses

Other names 1

• Avita of Brunswick Doing business as

Part of

Northbridge Avita Brunswick II LLC

Practitioners 1

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

• Kristen N Mitchell, D.O.

  • Family Medicine Physician
  • Saco, ME
  • NPI 1558561332
  NPD (past)

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551398400000",
    "number": "1508323247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 ADMIRAL FITCH AVE",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112700",
            "telephone_number": "207-729-0222",
            "fax_number": "207-729-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 ADMIRAL FITCH AVE",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112700",
            "telephone_number": "207-729-0222",
            "fax_number": "207-729-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHBRIDGE AVITA BRUNSWICK II LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHBRIDGE AVITA BRUNSWICK II LLC",
        "enumeration_date": "2019-03-01",
        "last_updated": "2019-03-01",
        "status": "A",
        "authorized_official_last_name": "NOWOKUNSKI",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-238-4856"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avita of Brunswick",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark A. Nickerson
• Flower Noble
• Kristina Nocella, DPT
• Jennifer M Noel, LCSW
• Alexis Leigh Nolan, CNM
• Northbridge Brunswick Assisted Living
• Allen Robert Northup, LCC LPE
• Jaime Norton, OTR/L
• NR Maine LLC
• Guy Nuki, MD

• Alzheimer Center (Dementia Center) in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Alzheimer Center (Dementia Center) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; 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.