Kathryn Wistar, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

017250 Issued in ME

Practice address

47 Main St
Coopers Mills, ME 04341

Phone

(207) 549-7581

Fax

(207) 549-3439

NPI assigned

Oct 5, 2006

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

Specialty

Family Practice

Education

University of North Carolina at Chapel Hill School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthreach Community Health CentersGroup PAC ID 5496726523, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maine General Medical Center Hospital, Augusta, ME, CCN 200039

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Healthreach Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Coopers Mills, ME
  • NPI 1841263118
  Medicare reassignment Care Compare group NPD
• Healthreach Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Fairfield, ME
  • NPI 1285302893
  NPD
• Healthreach Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Madison, ME
  • NPI 1184698441
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272931200000",
    "number": "1720175599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207",
            "city": "COOPERS MILLS",
            "state": "ME",
            "postal_code": "04341",
            "telephone_number": "207-549-7581",
            "fax_number": "207-549-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 MAIN ST",
            "city": "COOPERS MILLS",
            "state": "ME",
            "postal_code": "04341",
            "telephone_number": "207-549-7581",
            "fax_number": "207-549-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISTAR",
        "first_name": "KATHRYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2010-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "017250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann R Schaer, PA C
• Alexa A Shea, PA
• Anna Shepard
• Deirdre R Vander Schaaf, FNP
• Zachary Wissman, PA

• Family Medicine Physician in Coopers Mills, ME
• Providers in Coopers Mills, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.