Courtney L Daggett, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA1192 Issued in ME

Practice address

46 Fairview Ave Ste 111
Skowhegan, ME 04976-1481

Phone

(207) 474-3320

Fax

(207) 474-5067

NPI assigned

Nov 2, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Courtney L Theriault Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Redington-Fairview General Hospital

  • Critical Access Hospital
  • Skowhegan, ME
  • NPI 1174549133
  Medicare reassignment NPD
• Mainegeneral Medical Center

  • General Acute Care Hospital
  • Augusta, ME
  • NPI 1174858278
  Medicare reassignment
• Mainegeneral Medical Center

  • Community/Retail Pharmacy
  • Waterville, ME
  • NPI 1477344976
  NPD
• Redington-Fairview General Hospital

  • Rural Health Clinic/Center
  • Madison, ME
  • NPI 1851423008
  NPD

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1740516301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049760468",
            "telephone_number": "207-858-8353",
            "fax_number": "207-474-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 FAIRVIEW AVE STE 111",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049761481",
            "telephone_number": "207-474-3320",
            "fax_number": "207-474-5067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGGETT",
        "first_name": "COURTNEY",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA1192",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ME",
            "license": "PA1192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740516301",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "THERIAULT",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danielle Lee Cowan, DPT
• Kris Elizabeth Croteau, LCPC
• Daniel T. Crowley, LMT
• Michael P Curran, M.D.
• Poonam Dabbas
• Carmen Daigle
• Alice Virginie Dalco, DMD
• Melissa Lynn Dangler, PTA
• Molly Daniel, RN
• Florence Dasrath, MD

• Medical Physician Assistant in Skowhegan, ME
• Providers in Skowhegan, ME by specialty
• Medical Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.