Thi of Maine at Integrated Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

THI OF MAINE AT INTEGRATED REHAB LLC

Practice address

248 State Street
Brewer, ME 04412

Phone

(207) 989-2034

Fax

(207) 989-5971

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Scott Mayo

Title

President

Phone

(207) 989-2034

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Maine Center for Integrated Rehab LLC Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Outpatient physical therapy / speech pathology certification: CCN 206527

Legal name

MAINE CENTER FOR INTEGRATED REHABILITION

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Jul 12, 1999

Last certification

Sep 20, 2018

Ownership / control type

Proprietary

Most recent change of ownership

Jul 1, 2003

Facility address

248 State Street, Twin City Plaza
Brewer, ME 04412

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cara Brochu, DPT

  • Physical Therapist
  • Kennebunk, ME
  • NPI 1912238312
  NPD (past)
• Abigail M. Lourie, LCSW

  • Clinical Social Worker
  • Augusta, ME
  • NPI 1518102540
  NPD (past)
• Gary D. Schwartzberg, AUD, FAAA

  • Audiologist-Hearing Aid Fitter
  • Waterville, ME
  • NPI 1871556043
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1700975331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 STATE STREET",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "04412",
            "telephone_number": "207-989-2034",
            "fax_number": "207-989-5971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THI OF MAINE AT INTEGRATED REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-989-2034",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163490002",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99911053",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maine Center for Integrated Rehab LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Brewer, ME
• Providers in Brewer, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.