NPIMap

Organization Active NPI

Integrated Medical Associates, LLC

  • Internal Medicine Physician
  • Waterville, ME
National Provider Identifier
1639109366
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTEGRATED MEDICAL ASSOCIATES, LLC
Practice address
40 Airport Rd
Suite 2
Waterville, ME 04901-4524
Phone
(207) 680-2070
Fax
(207) 680-2074
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Authorized official

Name
John Hawkins Irwin III, D.O.
Title
Owner
Phone
(207) 680-2070

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X

Addresses

Primary practice location

40 Airport Rd
Suite 2
Waterville, ME 04901-4524

Mailing address

40 Airport Rd
Suite 2
Waterville, ME 04901-4524
Phone (207) 680-2070

Other identifiers 1

IdentifierTypeStateIssuer
197070000MedicaidME

National Provider Directory

National Provider Directory

Locations

30 Main St
Madison, ME 04950
Phone (207) 696-3880

25 First Park Dr
Ste A
Oakland, ME 04963
Phone (207) 873-4325

244 Kennedy Memorial Dr
Ste 203
Waterville, ME 04901
Phone (207) 680-2070

Practitioners & affiliated clinicians

Practitioners 57

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

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391644800000",
    "number": "1639109366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 AIRPORT RD",
            "address_2": "SUITE 2",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014524",
            "telephone_number": "207-680-2070",
            "fax_number": "207-680-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 AIRPORT RD",
            "address_2": "SUITE 2",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014524",
            "telephone_number": "207-680-2070",
            "fax_number": "207-680-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2014-02-06",
        "status": "A",
        "authorized_official_last_name": "IRWIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "HAWKINS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-680-2070",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197070000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; 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.