Individual provider Active NPI

Philip M Apolito, PHD

  • Psychologist
  • Waterville, ME
National Provider Identifier
1700828753
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS1189 Issued in ME
Practice address
30 Chase Ave
Waterville, ME 04901-4624
Phone
(207) 872-4680
Fax
(207) 872-4003
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS1189 ME Primary

Addresses

Primary practice location

30 Chase Ave
Waterville, ME 04901-4624

Mailing address

30 Chase Ave
Waterville, ME 04901-4624
Phone (207) 872-4303

Other identifiers 1

IdentifierTypeStateIssuer
154420000MedicaidME

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS1189MEMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1700828753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CHASE AVE",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014624",
            "telephone_number": "207-872-4303",
            "fax_number": "207-872-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CHASE AVE",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014624",
            "telephone_number": "207-872-4680",
            "fax_number": "207-872-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APOLITO",
        "first_name": "PHILIP",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "PS1189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154420000",
            "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 2, 2008; 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.