Individual provider Active NPI

Allan W Nyman, DPM

  • Podiatrist
  • Waterville, ME
National Provider Identifier
1679580963
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD136 Issued in ME
Practice address
316 Main St
Waterville, ME 04901-4921
Phone
(207) 873-2683
Fax
(207) 873-2683
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD136 ME Primary

Addresses

Primary practice location

316 Main St
Waterville, ME 04901-4921

Mailing address

316 Main St
Waterville, ME 04901-4921
Phone (207) 873-2683

Other identifiers 1

IdentifierTypeStateIssuer
000591OtherMEANTHEM BCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679580963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 MAIN ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014921",
            "telephone_number": "207-873-2683",
            "fax_number": "207-873-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 MAIN ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014921",
            "telephone_number": "207-873-2683",
            "fax_number": "207-873-2683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYMAN",
        "first_name": "ALLAN",
        "middle_name": "W",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "ME",
            "license": "POD136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000591",
            "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 Jul 8, 2007; 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.