Premier Physical Therapy-Midcoast, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PREMIER PHYSICAL THERAPY-MIDCOAST, LLC

Practice address

34 Hennessey Ave
Brunswick, ME 04011-2333

Phone

(207) 373-1101

Fax

(207) 373-1109

NPI assigned

May 27, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leo Credit, PTNPI 1477509115

Title

Indirect Owner

Phone

(207) 373-1101

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Gray Physical Therapy Center, PA

  • Physical Therapist
  • Gray, ME
  • NPI 1861449811

  Member Of

  NPD member

Practitioners 2

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.

• Leo R Credit Jr., PT

  • Physical Therapist
  • Gray, ME
  • NPI 1477509115
  NPD (past) Authorized official
• Dallas S Hartwig, PT

  • Physical Therapist
  • Brunswick, ME
  • NPI 1144277963
  NPD (past)

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609823756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 396",
            "city": "GRAY",
            "state": "ME",
            "postal_code": "040390396",
            "telephone_number": "207-373-1101",
            "fax_number": "207-373-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 HENNESSEY AVE",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112333",
            "telephone_number": "207-373-1101",
            "fax_number": "207-373-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICAL THERAPY-MIDCOAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CREDIT",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "INDIRECT OWNER",
        "authorized_official_telephone_number": "207-373-1101",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Power
• Renee M Powers, FNP
• Bhavini Prajapati, MD
• Terrance Preston Pratt, PT
• Preferred Therapy Outpatient Services of Me, LLC
• Hallie E Prince, NP
• Jean M Principe, PHD
• Proctology Associates of Maine PA (coastal Health and wellness)
• Providence Service Corporation of Maine
• Providence Service Corporation of Maine

• Physical Therapist in Brunswick, ME
• Providers in Brunswick, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.