Penobscot Respiratory

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

PENOBSCOT RESPIRATORY

Practice address

417 State St
Ste 400
Bangor, ME 04401-6630

Phone

(207) 942-6096

Fax

(207) 973-8857

NPI assigned

Jun 4, 2006

Organization subpart

No

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

Authorized official

Name

Thomas G Frey, MD

Title

President

Phone

(207) 942-6096

Specialties & licenses 1

Addresses

Locations

Practitioners 4

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

• Jessica Alicea-Santiago, FNP

  • Family Nurse Practitioner
  • Indian Island, ME
  • NPI 1306516836
  NPD
• Frederick A Oldenburg Jr., MD

  • Pulmonary Disease Physician
  • Bangor, ME
  • NPI 1083662571
  NPD
• Karen D Godin, PA-C

  • Physician Assistant
  • Bangor, ME
  • NPI 1104868603
  NPD (past)
• Ruth E Talley, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Bangor, ME
  • NPI 1417925645
  NPD (past)

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1710925201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 STATE ST",
            "address_2": "STE 400",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016630",
            "telephone_number": "207-942-6096",
            "fax_number": "207-973-8857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 STATE ST",
            "address_2": "STE 400",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016630",
            "telephone_number": "207-942-6096",
            "fax_number": "207-973-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENOBSCOT RESPIRATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "FREY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-942-6096",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penobscot Community Health Center
• Penobscot Community Health Center
• Penobscot Community Health Center
• Penobscot Community Health Center
• Penobscot Family Foot and Ankle Center
• Penobscot Surgical Care, P.a.
• Penobscot Valley Dermatology, P.a.
• Penquis C.a.P., Inc.
• Penquis C.a.P., Inc.
• Penquis C.a.P., Inc.

• Pulmonary Disease Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Pulmonary Disease Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.