Active NPI
University of Southern Maine
- Primary Care Nurse Practitioner
- Gorham, ME
National Provider Identifier
1518201250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 21136
- Legal business name
- UNIVERSITY OF SOUTHERN MAINE
- Practice address
- 37 College Ave
125 Upton Hall
Gorham, ME 04038-1032 - Phone
- (207) 780-5411
- Fax
- (207) 780-4911
- NPI assigned
- Nov 19, 2012
- Organization subpart
- Yes
- Parent organization
- UNIVERSITY OF MAINE SYSTEM
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Lisa Garner Belanger, APRN
- Title
- Director, Health Services
- Phone
- (207) 780-5160
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 21136 | ME | Primary |
Addresses
Primary practice location
37 College Ave
125 Upton Hall
Gorham, ME 04038-1032
Mailing address
37 College Ave
125 Upton Hall
Gorham, ME 04038-1032
Phone (207) 780-5411
Other names 1
- Health & Counseling Services
National Provider Directory
National Provider Directory- Part of
- University of Southern Maine
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Gorham, ME
- NPI 1285759993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353283200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1353283200000",
"number": "1518201250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 COLLEGE AVE",
"address_2": "125 UPTON HALL",
"city": "GORHAM",
"state": "ME",
"postal_code": "040381032",
"telephone_number": "207-780-5411",
"fax_number": "207-780-4911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37 COLLEGE AVE",
"address_2": "125 UPTON HALL",
"city": "GORHAM",
"state": "ME",
"postal_code": "040381032",
"telephone_number": "207-780-5411",
"fax_number": "207-780-4911"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNIVERSITY OF SOUTHERN MAINE",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "UNIVERSITY OF MAINE SYSTEM",
"enumeration_date": "2012-11-19",
"last_updated": "2012-11-19",
"status": "A",
"authorized_official_last_name": "BELANGER",
"authorized_official_first_name": "LISA",
"authorized_official_middle_name": "GARNER",
"authorized_official_title_or_position": "DIRECTOR, HEALTH SERVICES",
"authorized_official_telephone_number": "207-780-5160",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "APRN"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": "ME",
"license": "21136",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Health & Counseling Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Gorham, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.