Organization Active NPI

Paul N. Smith, M.D., P.a.

  • Specialist
  • Bangor, ME
National Provider Identifier
1629112792
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PAUL N. SMITH, M.D., P.A.
Doing business as
Bangor OB/GYN
Practice address
68 Mount Hope Ave
Bangor, ME 04401-4096
Phone
(207) 945-6588
Fax
(207) 945-2955
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Authorized official

Name
Brenda Kenney
Title
Office Manager
Phone
(207) 945-6588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

68 Mount Hope Ave
Bangor, ME 04401-4096

Mailing address

68 Mount Hope Ave
Bangor, ME 04401-4096
Phone (207) 945-6588

Other identifiers 3

IdentifierTypeStateIssuer
0004661923OtherMEAETNA
060976OtherMEANTHEM
228520000MedicaidME

Other names 1

  • Bangor OB/GYN Doing business as

National Provider Directory

National Provider Directory

Locations

12 Stillwater Ave
Ste 1
Bangor, ME 04401
Phone (207) 945-6588

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1629112792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 MOUNT HOPE AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014096",
            "telephone_number": "207-945-6588",
            "fax_number": "207-945-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 MOUNT HOPE AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014096",
            "telephone_number": "207-945-6588",
            "fax_number": "207-945-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL N. SMITH, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "KENNEY",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "207-945-6588"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0004661923",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "060976",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228520000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bangor OB/GYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.