Mainely Kidz PT

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT1834 Issued in ME

Legal business name

MAINELY KIDZ PT

Practice address

205 Bolt Hill Rd
Eliot, ME 03903-1942

Phone

(207) 439-5104

Fax

(207) 571-8134

NPI assigned

Jan 29, 2009

Last updated

Jan 29, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer CorbeilNPI 1699781104

Title

President

Phone

(207) 439-5104

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Corbeil, PT

  • Pediatric Physical Therapist
  • Eliot, ME
  • NPI 1699781104
  NPD (past) Authorized official

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233187200000",
    "number": "1730327792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 BOLT HILL RD",
            "city": "ELIOT",
            "state": "ME",
            "postal_code": "039031942",
            "telephone_number": "207-439-5104",
            "fax_number": "207-571-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 BOLT HILL RD",
            "city": "ELIOT",
            "state": "ME",
            "postal_code": "039031942",
            "telephone_number": "207-439-5104",
            "fax_number": "207-571-8134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINELY KIDZ PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A",
        "authorized_official_last_name": "CORBEIL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-439-5104"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ME",
            "license": "PT1834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George F. Kloda, PHARMACIST
• Diane Marie Kraszewski, D.C.
• Leslie Parker Physical Therapy (Inner Balance Physical Therapy)
• Jennifer Loichle, NP
• Maine Tiny Dental Eliot LLC
• Elizabeth Ann Marcotte, MSW, LCSW, LICSW
• Tracy Mattheson
• Amy J McClellan, RD
• Carleen Messina, D.O.
• Jennifer Ann Michaud, LCPC

• Physical Therapy Clinic/Center in Eliot, ME
• Providers in Eliot, ME by specialty
• Physical Therapy Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.