Southern Maine Gastroenterology, LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

SOUTHERN MAINE GASTROENTEROLOGY, LLC

Practice address

10 Storer St
Unit 106, Lafayette Center
Kennebunk, ME 04043-6875

Phone

(207) 467-9156

Fax

(207) 467-9157

NPI assigned

Nov 24, 2006

Organization subpart

No

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

Authorized official

Name

John Thompson, DONPI 1568448637

Title

Provider

Phone

(207) 467-9156

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John W Thompson, D.O.

  • Gastroenterology Physician
  • Kennebunk, ME
  • NPI 1568448637
  NPD (past) Authorized official
• Richard Sydney Stockwell, DO

  • Colon & Rectal Surgery Physician
  • Westbrook, ME
  • NPI 1275570541
  NPD (past)

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1609941509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PMB 2700",
            "address_2": "4 SCAMMON ST, SUITE 19",
            "city": "SACO",
            "state": "ME",
            "postal_code": "04072",
            "telephone_number": "207-282-4704",
            "fax_number": "207-286-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 STORER ST",
            "address_2": "UNIT 106, LAFAYETTE CENTER",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436875",
            "telephone_number": "207-467-9156",
            "fax_number": "207-467-9157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MAINE GASTROENTEROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "207-467-9156",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1428193",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "878196",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432448100",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• SMMC Visiting Nurses
• SMMC Visiting Nurses
• Snow Moon Therapy Services LLC
• Penelope Faith Snow, LCSW
• Southern Maine Gastroenterology, LLC
• Southern Maine Health Care
• Southern Maine Integrative Health Center, LLC
• Ashley St. Amand, L.AC.
• Thomas Henry St. Amand, LIC. AC.
• Scott Karl Stackhouse, PT

• Gastroenterology Physician in Kennebunk, ME
• Providers in Kennebunk, ME by specialty
• Gastroenterology Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.