Exline Health, LLC

Key facts

NPI

1669133237

Entity type

Organization (NPI type 2)

Primary specialty

Nurse Practitioner 363L00000X

Legal business name

EXLINE HEALTH, LLC

Practice address

5 School St
Ellsworth, ME 04605-1932

Phone

(207) 613-7500

Fax

(207) 613-7600

NPI assigned

Jan 6, 2022

Organization subpart

No

Authorized official

Name

Kimberly A Marshall, NP NPI 1639573421

Title

Owner

Phone

(207) 613-7500

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

• Kimberly Ann Marshall, NP Adult Health Nurse Practitioner · Ellsworth, ME · NPI 1639573421
  Medicare reassignment NPD Authorized official ME

Medicare participation

Medicare fee-for-service enrollment

Enrolled in ME

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 1, 2022.

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656633600000",
    "number": "1669133237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SCHOOL ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051932",
            "telephone_number": "207-613-7500",
            "fax_number": "207-613-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SCHOOL ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051932",
            "telephone_number": "207-613-7500",
            "fax_number": "207-613-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXLINE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-613-7500",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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