Active NPI
Mary Marshall Overstreet, MD
- Psychiatry Physician
- Bangor, ME
National Provider Identifier
1710912852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 013408
- Practice address
- 656 State St
Bangor, ME 04401-5609 - Phone
- (207) 941-4073
- Fax
- (207) 941-4062
- NPI assigned
- Jul 11, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 013408 | ME | Primary |
Addresses
Primary practice location
656 State St
Bangor, ME 04401-5609
Mailing address
656 State St
Bangor, ME 04401-5609
Phone (207) 941-4073
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013408 | ME | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Maine | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710912852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "656 STATE ST",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015609",
"telephone_number": "207-941-4073",
"fax_number": "207-941-4062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "656 STATE ST",
"city": "BANGOR",
"state": "ME",
"postal_code": "044015609",
"telephone_number": "207-941-4073",
"fax_number": "207-941-4062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVERSTREET",
"first_name": "MARY MARSHALL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ME",
"license": "013408",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bangor, 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.