Bonnie Rae Condon

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

BONNIE RAE CONDON

Practice address

3101 Portage Rd
Portage Lake, ME 04768-3111

Phone

(207) 435-6726

Fax

(207) 435-6949

NPI assigned

Mar 6, 2009

Organization subpart

No

Name

Mrs. Bonnie Rae Condon

Title

Care Provider

Phone

(207) 435-6726

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 6, 2009.

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1629218409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 PORTAGE RD",
            "city": "PORTAGE LAKE",
            "state": "ME",
            "postal_code": "047683111",
            "telephone_number": "207-435-6726",
            "fax_number": "207-435-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 PORTAGE RD",
            "city": "PORTAGE LAKE",
            "state": "ME",
            "postal_code": "047683111",
            "telephone_number": "207-435-6726",
            "fax_number": "207-435-6949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNIE RAE CONDON",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-06",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "CARE PROVIDER",
        "authorized_official_telephone_number": "207-435-6726",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadine Edwarda Connor, DNP, MSN, APRN, BC
• Terriann Demerchant

• All providers in Portage Lake, ME
• Mental Illness Community Based Residential Treatment Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.