Individual provider Active NPI

Stephen Jon Doyle, PA-C

  • Physician Assistant
  • Augusta, ME
National Provider Identifier
1679687461
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-589 Issued in ME
Practice address
1 VA Center
MC 116a - U.S. Department of Veterans Affairs
Augusta, ME 04330
Phone
(207) 623-8411
Fax
(207) 621-7359
NPI assigned
Aug 18, 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
Physician Assistant 363A00000X PA-589 ME Primary

Addresses

Primary practice location

1 VA Center
MC 116a - U.S. Department of Veterans Affairs
Augusta, ME 04330

Mailing address

111 Gayton LN
Winthrop, ME 04364-3725
Phone (207) 623-8411

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

State licenses

LicenseStateTypeSpecialty
PA-589MEMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679687461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GAYTON LN",
            "city": "WINTHROP",
            "state": "ME",
            "postal_code": "043643725",
            "telephone_number": "207-623-8411",
            "fax_number": "207-621-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 VA CENTER",
            "address_2": "MC 116A - U.S. DEPARTMENT OF VETERANS AFFAIRS",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "04330",
            "telephone_number": "207-623-8411",
            "fax_number": "207-621-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "STEPHEN",
        "middle_name": "JON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA-589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 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.