NPIMap

Organization Active NPI

Kennebec Valley Radiology Professional Association

  • Diagnostic Radiology Physician
  • Augusta, ME
National Provider Identifier
1730158734
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
KENNEBEC VALLEY RADIOLOGY PROFESSIONAL ASSOCIATION
Practice address
28 Arsenal St
Augusta, ME 04330-5226
Phone
(207) 622-4231
Fax
(207) 623-1580
NPI assigned
Mar 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Authorized official

Name
Mrs. Pamela S Mansir
Title
Business Manager
Phone
(207) 622-4231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

28 Arsenal St
Augusta, ME 04330-5226

Mailing address

28 Arsenal St
Augusta, ME 04330-5226
Phone (207) 622-4231

Other identifiers 5

IdentifierTypeStateIssuer
101613OtherMEBC/BS OF MASS
0607OtherMEANTHEM BC/BS OF MAINE
106860000MedicaidME
0062588OtherMEAETNA
0607OtherMEFEDERAL BC/BS

National Provider Directory

National Provider Directory

Locations

28 Arsenal St
Augusta, ME 04330
Phone (207) 622-4231

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1730158734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 ARSENAL ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305226",
            "telephone_number": "207-622-4231",
            "fax_number": "207-623-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 ARSENAL ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043305226",
            "telephone_number": "207-622-4231",
            "fax_number": "207-623-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEBEC VALLEY RADIOLOGY PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "MANSIR",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "207-622-4231",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MASS",
            "identifier": "101613",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS OF MAINE",
            "identifier": "0607",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106860000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0062588",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BC/BS",
            "identifier": "0607",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.