Organization Active NPI

Sunbury Primary Care, P.a.

Doing business as Winterport Family Medicine

  • Family Medicine Physician
  • Winterport, ME
National Provider Identifier
1679668180
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUNBURY PRIMARY CARE, P.A.
Doing business as
Winterport Family Medicine
Practice address
775 N Main Rd
Winterport, ME 04496
Phone
(207) 223-5074
Fax
(207) 223-5953
NPI assigned
Oct 3, 2006
Last updated
Jun 4, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
SUNBURY PRIMARY CARE, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Authorized official

Name
David L Savell
Title
Chief Executive Officer
Phone
(207) 942-7650

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X
Physician Assistant 363A00000X
Family Nurse Practitioner 363LF0000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

775 N Main Rd
Winterport, ME 04496

Mailing address

PO Box 921
Bangor, ME 04402-0921
Phone (207) 990-0864

Other names 1

  • Winterport Family Medicine Doing business as

National Provider Directory

National Provider Directory
Part of
Sunbury Primary Care PA

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275609600000",
    "number": "1679668180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 921",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044020921",
            "telephone_number": "207-990-0864",
            "fax_number": "207-990-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 N MAIN RD",
            "city": "WINTERPORT",
            "state": "ME",
            "postal_code": "04496",
            "telephone_number": "207-223-5074",
            "fax_number": "207-223-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNBURY PRIMARY CARE, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNBURY PRIMARY CARE, P.A.",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-06-04",
        "status": "A",
        "authorized_official_last_name": "SAVELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "207-942-7650"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winterport Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winterport, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; 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.