Individual provider Active NPI

Joanna Cates Liberatore, FNP-C

  • Family Nurse Practitioner
  • Brewer, ME
National Provider Identifier
1619084076
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R 043562 Issued in ME
Practice address
191 S Main St Unit 6
Brewer, ME 04412-2307
Phone
(207) 461-5909
Fax
(207) 407-7231
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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 R 043562 ME Primary

Addresses

Primary practice location

191 S Main St Unit 6
Brewer, ME 04412-2307

Mailing address

191 S Main St Unit 6
Brewer, ME 04412-2307
Phone (207) 659-8428

Other identifiers 1

IdentifierTypeStateIssuer
AANP CERTIFICATE NO.OtherF0604005

Other names 1

  • Joanna Marie Cates Former name

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
I20070219000727 ME Practitioner - Nurse Practitioner 2567419294

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 043562MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Jul 31, 2006 Accepting new patients
Eastern Maine Medical Center CurrentSince Jul 31, 2006 Accepting new patients

Locations

489 State St
Bangor, ME 04401
Phone (207) 973-8837

931 Union St
Fl 3
Bangor, ME 04401

43 Whiting Hill Rd
Brewer, ME 04412
Phone (207) 973-5000

43 Whiting Hill Rd
Ste 300
Brewer, ME 04412
Phone (207) 973-5000

5721 Cutler Health Ctr
Orono, ME 04469
Phone (207) 581-4000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1619084076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 S MAIN ST UNIT 6",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044122307",
            "telephone_number": "207-659-8428",
            "fax_number": "207-407-7231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S MAIN ST UNIT 6",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044122307",
            "telephone_number": "207-461-5909",
            "fax_number": "207-407-7231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERATORE",
        "first_name": "JOANNA",
        "middle_name": "CATES",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "R 043562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "F0604005",
            "identifier": "AANP CERTIFICATE NO.",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "CATES",
            "middle_name": "MARIE",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brewer, ME

Sources for this page

Verify at the official NPI Registry.