Individual provider Active NPI

Jesica L Todd-Brown, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lewiston, ME
National Provider Identifier
1568700151
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP121124 Issued in ME
Practice address
100 Campus Ave
Suite 208
Lewiston, ME 04240-6040
Phone
(207) 777-8974
Fax
(207) 777-8946
NPI assigned
Jan 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP121124 ME Primary

Addresses

Primary practice location

100 Campus Ave
Suite 208
Lewiston, ME 04240-6040

Mailing address

PO Box 10187
Albany, NY 12201-5187
Phone (207) 777-4111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130606000274 ME Practitioner - Nurse Practitioner 4284872045 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP121124MEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Clinical Services, Inc CurrentSince Mar 28, 2013 Accepting new patients
State of Maine Current Accepting new patients
State of Maine CurrentSince Jul 25, 2022 Accepting new patients
Community Clinical Services, Inc. CurrentSince Mar 28, 2013 Accepting new patients
St. Mary's Regional Medical Center CurrentSince Jan 1, 2017 Accepting new patients
St. Mary's Regional Medical Center CurrentSince Jan 1, 2017 Accepting new patients

Locations

109 Capitol St
#11
Augusta, ME 04330

656 State St
Bangor, ME 04401
Phone (207) 941-4000

106 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3383

93 Campus Ave
#I2
Lewiston, ME 04240
Phone (207) 777-4420

100 Campus Ave
Ste 208
Lewiston, ME 04240
Phone (207) 777-8974

93 Campus Ave
Lewiston, ME 04240
Phone (207) 755-3715

Organizations & group practices 6

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": "1358380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1568700151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10187",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122015187",
            "telephone_number": "207-777-4111",
            "fax_number": "207-783-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CAMPUS AVE",
            "address_2": "SUITE 208",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406040",
            "telephone_number": "207-777-8974",
            "fax_number": "207-777-8946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD-BROWN",
        "first_name": "JESICA",
        "middle_name": "L",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-17",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP121124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

Verify at the official NPI Registry.