Active NPI
Colby W Nixon, DO
- Internal Medicine Physician
- Portland, ME
National Provider Identifier
1740740315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- DO3911
- Practice address
- 22 Bramhall St
Portland, ME 04102-3175 - Phone
- (207) 662-0111
- NPI assigned
- Mar 21, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 292791 | MA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | DO3911 | ME | Primary |
| Internal Medicine Physician | 207R00000X | 292791 | MA |
Addresses
Primary practice location
22 Bramhall St
Portland, ME 04102-3175
Mailing address
22 Bramhall St
Portland, ME 04102-3175
Phone (207) 662-0111
Other practice location 1
759 Chestnut St Ste C3350
Springfield, MA 01107-1619
Phone (413) 794-6297
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
22 Bramhall St
Portland, ME 04102-3134
Phone (207) 706-3280
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 292791 | MA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients | |
| Mainehealth | Current | Accepting new patients |
Locations
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
Interoperability endpoints
- cnixon881213@direct.mmc.mainehealth.org
Organizations & group practices 3
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.
-
- Psychiatric Hospital
- Westbrook, ME
- NPI 1790265502
-
- Community/Retail Pharmacy
- Portland, ME
- NPI 1013868181
-
- General Acute Care Hospital
- Portland, ME
- NPI 1760436216
Hospital & facility affiliations 36
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Scarborough, ME
- NPI 1053647024
-
- General Acute Care Hospital
- Portland, ME
- NPI 1346267879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726444800000",
"number": "1740740315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023175",
"telephone_number": "207-662-0111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023175",
"telephone_number": "207-662-0111"
}
],
"practiceLocations": [
{
"address_1": "759 Chestnut St Ste C3350",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "MA",
"postal_code": "011071619",
"country_code": "US",
"telephone_number": "413-794-6297",
"fax_number": "413-794-1767",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NIXON",
"first_name": "COLBY",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-21",
"last_updated": "2024-09-16",
"certification_date": "2024-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MA",
"license": "292791",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "ME",
"license": "DO3911",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "292791",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.