Maine Osteopathic Medicine, LLC

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

1663 Issued in ME

Legal business name

MAINE OSTEOPATHIC MEDICINE, LLC

Practice address

146 Ocean St
Suite 2
South Portland, ME 04106-3664

Phone

(207) 747-4455

Fax

(888) 907-5762

NPI assigned

Apr 19, 2013

Last updated

Apr 19, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie W Collins, D.O.NPI 1073599791

Title

Physician/Owner

Phone

(207) 747-4455

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie W Collins, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • South Portland, ME
  • NPI 1073599791
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366329600000",
    "number": "1659715738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2293",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041162293",
            "telephone_number": "207-747-4455",
            "fax_number": "888-907-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 OCEAN ST",
            "address_2": "SUITE 2",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041063664",
            "telephone_number": "207-747-4455",
            "fax_number": "888-907-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINE OSTEOPATHIC MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-19",
        "last_updated": "2013-04-19",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "207-747-4455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "1663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mainehealth
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• Neuromusculoskeletal Medicine & OMM Physician in South Portland, ME
• Providers in South Portland, ME by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.