NPIMap

Organization Active NPI

State of Maine

  • Case Management Agency
  • Augusta, ME
National Provider Identifier
1649413360
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
NONE Issued in ME
Legal business name
STATE OF MAINE
Practice address
32 Blossom LN
Augusta, ME 04333-0001
Phone
(207) 287-4242
Fax
(207) 287-9915
NPI assigned
Apr 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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

Authorized official

Name
Jennifer Gagnon
Title
Financial Manager
Phone
(207) 624-4675

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NONE ME Primary

Addresses

Primary practice location

32 Blossom LN
Augusta, ME 04333-0001

Mailing address

109 Capitol Street SHS#11 Reimbursement Unit
Augusta, ME 04333-0011
Phone (207) 287-7418

Other identifiers 6

IdentifierTypeStateIssuer
135910312MedicaidME
135910315MedicaidME
135910304MedicaidME
135910313MedicaidME
135910314MedicaidME
135910311MedicaidME

Other names 1

  • OACPDS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pineland Center8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

32 Blossom Ln
Augusta, ME 04330
Phone (207) 287-6642

NPI Registry JSON

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

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560470400000",
    "number": "1649413360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CAPITOL STREET SHS#11 REIMBURSEMENT UNIT",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043330011",
            "telephone_number": "207-287-7418",
            "fax_number": "207-287-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 BLOSSOM LN",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043330001",
            "telephone_number": "207-287-4242",
            "fax_number": "207-287-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF MAINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-10",
        "last_updated": "2019-06-14",
        "status": "A",
        "authorized_official_last_name": "GAGNON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "207-624-4675"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "ME",
            "license": "NONE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135910312",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135910315",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135910304",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135910313",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135910314",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135910311",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OACPDS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OACPDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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.