NPIMap

Individual provider Active NPI

Kelly L Osborne, FNP

  • Family Nurse Practitioner
  • Portland, ME
National Provider Identifier
1699023432
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP121071 Issued in ME
Practice address
22 Bramhall Street
Portland, ME 04102
Phone
(207) 662-5610
Fax
(207) 662-3790
NPI assigned
Aug 28, 2012
Last updated
Feb 27, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP121071 ME Primary

Addresses

Primary practice location

22 Bramhall Street
Portland, ME 04102

Mailing address

301C US Route 1
Scarborough, ME 04074-9701
Phone (207) 396-8600

Other names 1

  • Kelly L Madore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121120000243 ME Practitioner - Nurse Practitioner 2062663164 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, 2,616 clinicians

Practice addresses (Care Compare)

1 Harnois Ave
Westbrook, ME 04092-4392
Phone (207) 662-1360

1 Harnois Ave
Westbrook, ME 04092-4395

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Jan 1, 2014 Accepting new patients
Maine Medical Partners Current Accepting new patients
Mainehealth CurrentSince Oct 2, 2017 Accepting new patients
Mainehealth CurrentSince Jan 1, 2014 Accepting new patients
Maine Medical Partners CurrentSince Sep 7, 2012 Accepting new patients
Maine Medical Partners CurrentSince Jun 10, 2019 Accepting new patients
Maine Medical Partners CurrentSince Jun 10, 2019 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth CurrentSince Oct 2, 2017 Accepting new patients
Maine Medical Partners CurrentSince Sep 7, 2012 Accepting new patients

Locations

181 Main St
Norway, ME 04268
Phone (207) 743-5933

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

100 Campus Dr
Unit 107
Scarborough, ME 04074
Phone (207) 396-7565

301C US Route 1
Scarborough, ME 04074
Phone (207) 396-8600

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

1 Harnois Ave
Ste 2
Westbrook, ME 04092
Phone (207) 661-3400

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: kmadore35498@direct.mmc.mainehealth.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 39

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1699023432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BRAMHALL STREET",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04102",
            "telephone_number": "207-662-5610",
            "fax_number": "207-662-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP121071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MADORE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.