Mary W Tibbetts, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

017199 Issued in ME

Practice address

6 E Chestnut St
Augusta, ME 04330-5717

Phone

(207) 626-1275

Fax

(207) 626-1985

NPI assigned

Oct 5, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• State of Maine

  • Psychiatric Hospital
  • Bangor, ME
  • NPI 1699776146
  Medicare reassignment NPD
• State of Maine

  • Psychiatric Hospital
  • Augusta, ME
  • NPI 1053319566
  NPD
• Jwalant Vadalia MD PC

  • Psychiatry Physician
  • Manchester, NH
  • NPI 1346329133
  NPD (past)

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215388800000",
    "number": "1700873569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305717",
            "telephone_number": "207-626-1275",
            "fax_number": "207-621-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 E CHESTNUT ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305717",
            "telephone_number": "207-626-1275",
            "fax_number": "207-626-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBETTS",
        "first_name": "MARY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2008-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ME",
            "license": "017199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Thompson
• Sigrun Thompson, P.T.A.
• Amanda Elaine Thorne, CADC, MHRT/C
• Abby R Thrower, MD PH.D.
• Tonya E Thurlow, MSW-CC
• Patrick L Tibbetts, PTA
• Timm & Desrosiers DMD
• Jeffrey Mead Timm, DMD
• Genis R Timmerman, LMFT
• Katie Tims, COTA/L

• Psychiatry Physician in Augusta, ME
• Providers in Augusta, ME by specialty
• Psychiatry Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.