Organization Active NPI

Scarborough Integrative Health, P.a.

  • Family Medicine Physician
  • Scarborough, ME
National Provider Identifier
1568979631
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD17055 Issued in ME
Legal business name
SCARBOROUGH INTEGRATIVE HEALTH, P.A.
Practice address
51 US Route 1 Ste a
Scarborough, ME 04074-7145
Phone
(207) 396-1440
Fax
(207) 289-3104
NPI assigned
Jan 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Authorized official

Name
Jill D Mahoney, MD
Title
Physician/Owner
Phone
(207) 396-1440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD17055 ME Primary

Addresses

Primary practice location

51 US Route 1 Ste a
Scarborough, ME 04074-7145

Mailing address

51 US Route 1 Ste a
Scarborough, ME 04074-7145
Phone (207) 396-1440

National Provider Directory

National Provider Directory

Locations

51 US Route 1
Ste A
Scarborough, ME 04074
Phone (207) 396-1440

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515542400000",
    "number": "1568979631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 US ROUTE 1 STE A",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747145",
            "telephone_number": "207-396-1440",
            "fax_number": "207-289-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 US ROUTE 1 STE A",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040747145",
            "telephone_number": "207-396-1440",
            "fax_number": "207-289-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCARBOROUGH INTEGRATIVE HEALTH, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-01-10",
        "status": "A",
        "authorized_official_last_name": "MAHONEY",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "207-396-1440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD17055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; 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.