NPIMap

Organization Active NPI

Spectrum Medical Group, P.a.

  • Diagnostic Radiology Physician
  • Bangor, ME
National Provider Identifier
1639577620
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SPECTRUM MEDICAL GROUP, P.A.
Practice address
489 State St
Bangor, ME 04401-6616
Phone
(207) 482-7800
NPI assigned
Dec 8, 2014
Organization subpart
Yes
Parent organization
SPECTRUM MEDICAL GROUP, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Authorized official

Name
David Landry
Title
Chief Executive Officer
Phone
(207) 482-7800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

489 State St
Bangor, ME 04401-6616

Mailing address

PO Box 138
Lewiston, ME 04243-0138

Other names 1

  • Northern Radiology Associates of Maine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spectrum Healthcare Partners PA6 organizations share this tax ID, including this one
Part of
Spectrum Healthcare Partners PA

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1639577620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 138",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042430138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-482-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM MEDICAL GROUP, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM MEDICAL GROUP, P.A.",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "LANDRY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "207-482-7800"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Radiology Associates of Maine",
            "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 Dec 8, 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.