NPIMap

Organization Active NPI

Northern Maine Medical Center

  • Critical Access Hospital
  • Fort Kent, ME
National Provider Identifier
1568465144
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
NORTHERN MAINE MEDICAL CENTER
Practice address
194 East Main Street
Fort Kent, ME 04743-1428
Phone
(207) 834-3155
Fax
(207) 834-2949
NPI assigned
May 27, 2005
Last updated
Dec 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Authorized official

Name
Mr. Jeffrey Zewe
Title
Ceo
Phone
(207) 834-1411

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 36151 ME
General Acute Care Hospital 282N00000X 36943 ME
General Acute Care Hospital 282N00000X 37310 ME
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

194 East Main Street
Fort Kent, ME 04743-1428

Mailing address

194 East Main Street
Fort Kent, ME 04743-1428
Phone (207) 834-3155

Other identifiers 2

IdentifierTypeStateIssuer
000065OtherMEANTHEM BCBS PROVIDER #
999020397MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040511000177 ME Part B Supplier - Clinic/Group Practice 8426952987 Receives reassigned benefits from 130 practitioners
Practice locations: Fort Kent, ME; Madawaska, ME
O20240111004081 ME Part A Provider - Critical Access Hospital 3375455207 Receives reassigned benefits from 16 practitioners
2 other NPIs on this enrollment
Practice locations: Madawaska, ME; Fort Kent, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568465144. Details of each certification follow.

Hospital certification: CCN 201317

Legal name
NORTHERN MAINE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Nov 21, 2024
Last certification
Nov 21, 2024
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 5, 1940 in ME
Enrollment address
194 E Main St
Fort Kent, ME 47431428
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Northern Maine Medical CenterCCN 201317 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gisele Dionne Individual Corporate DirectorBoard Member Jan 30, 2019
Lucie Tabor Individual Corporate DirectorBoard Member Jan 15, 2021
Daniel Vaillancourt Individual Corporate DirectorBoard Member Jan 1, 2020
John Ezzy Individual Corporate DirectorBoard Member Jan 1, 2022
Steven Ouellette Individual Corporate DirectorBoard Member Jan 15, 2021
Jeffrey Zewe Individual Corporate OfficerCeo May 1, 2022
W-2 Managing EmployeeCeo May 1, 2022
Aaron Teachout Individual Corporate OfficerCfo Sep 30, 2021
W-2 Managing EmployeeCfo Sep 30, 2021
Norman L Fournier Individual Corporate DirectorBoard Member Jan 15, 2021
Donald Guimond Individual Corporate DirectorBoard Member, Chair Jul 21, 2015
Erin Soucy Individual Corporate DirectorBoard Member, Vice Chair Jun 28, 2016
Douglas Cyr Individual Corporate DirectorBoard Member Jan 1, 2020
Alain Bois Individual Corporate OfficerCoo Mar 29, 2021
W-2 Managing EmployeeCoo Mar 29, 2021
James V Harris Individual Corporate DirectorBoard Member Jun 20, 2023
Steven Pelletier Individual Corporate DirectorBoard Member Jan 1, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 136

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 136

Affiliated clinicians 129

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 129

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1568465144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 EAST MAIN STREET",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "047431428",
            "telephone_number": "207-834-3155",
            "fax_number": "207-834-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 EAST MAIN STREET",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "047431428",
            "telephone_number": "207-834-3155",
            "fax_number": "207-834-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MAINE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "ZEWE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-834-1411",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "ME",
            "license": "36151",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "ME",
            "license": "36943",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "ME",
            "license": "37310",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS PROVIDER #",
            "identifier": "000065",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "999020397",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Kent, ME

Sources for this page

Verify at the official NPI Registry.