Active NPI
Courtney Irene Maccallum, AGACNP
- Acute Care Nurse Practitioner
- Portland, ME
National Provider Identifier
1629966759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- CNP251297
- Practice address
- 887 Congress St Ste 400
Portland, ME 04102-3163 - Phone
- (207) 774-6368
- Fax
- (207) 774-9388
- NPI assigned
- Jun 26, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | CNP251297 | ME | |
| Acute Care Nurse Practitioner | 363LA2100X | CNP251297 | ME | Primary |
Addresses
Primary practice location
887 Congress St Ste 400
Portland, ME 04102-3163
Mailing address
887 Congress St Ste 400
Portland, ME 04102-3163
Phone (207) 774-6368
Other practice location 1
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 662-0111
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP251297 | ME | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients |
Locations
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
887 Congress St
Ste 400
Portland, ME 04102
Phone (207) 774-6368
Interoperability endpoints
- cshaban119559@direct.mmc.mainehealth.org
Organizations & group practices 3
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.
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- Multi-Specialty Clinic/Center
- Brunswick, ME
- NPI 1902422561
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780876800000",
"number": "1629966759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "887 CONGRESS ST STE 400",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023163",
"telephone_number": "207-774-6368",
"fax_number": "207-774-9388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "887 CONGRESS ST STE 400",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023163",
"telephone_number": "207-774-6368",
"fax_number": "207-774-9388"
}
],
"practiceLocations": [
{
"address_1": "22 Bramhall St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "ME",
"postal_code": "041023134",
"country_code": "US",
"telephone_number": "207-662-0111",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MACCALLUM",
"first_name": "COURTNEY",
"middle_name": "IRENE",
"credential": "AGACNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-26",
"last_updated": "2026-06-08",
"certification_date": "2026-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "ME",
"license": "CNP251297",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "ME",
"license": "CNP251297",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.