Individual provider Active NPI

Gloria I. Oppen, NP

  • Family Nurse Practitioner
  • Kennebunk, ME
National Provider Identifier
1598957755
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP171124 Issued in ME
Practice address
69 York St Ste 4
Kennebunk, ME 04043
Phone
(207) 985-3079
Fax
(207) 985-3775
NPI assigned
Aug 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP171124 ME Primary

Addresses

Primary practice location

69 York St Ste 4
Kennebunk, ME 04043

Mailing address

69 York St Ste 4
Kennebunk, ME 04043-7186
Phone (207) 985-3079

Other practice location 1

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-6034 ext. 28517

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
I20190404001203 ME Practitioner - Nurse Practitioner 7315288123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP171124MEMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1598957755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 YORK ST STE 4",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040437186",
            "telephone_number": "207-985-3079",
            "fax_number": "207-985-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 YORK ST STE 4",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "04043",
            "telephone_number": "207-985-3079",
            "fax_number": "207-985-3775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Francis St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156110",
            "country_code": "US",
            "telephone_number": "617-732-6034 x28517",
            "fax_number": "617-975-0808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OPPEN",
        "first_name": "GLORIA",
        "middle_name": "I.",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP171124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennebunk, ME

Sources for this page

Verify at the official NPI Registry.