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Individual provider Active NPI

Christine Blake Smith, DO

  • Addiction Medicine (Family Medicine) Physician
  • Westbrook, ME
National Provider Identifier
1760531180
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
DO2350 Issued in ME
Practice address
114 Stroudwater St
Westbrook, ME 04092-4037
Phone
(207) 856-6792
Fax
(207) 854-1146
NPI assigned
Jan 9, 2007
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X DO2350 ME
Family Medicine Physician 207Q00000X DO2350 ME
Addiction Medicine (Family Medicine) Physician 207QA0401X DO2350 ME Primary

Addresses

Primary practice location

114 Stroudwater St
Westbrook, ME 04092-4037

Mailing address

114 Stroudwater St
Westbrook, ME 04092-4037
Phone (207) 856-6792

Other identifiers 1

IdentifierTypeStateIssuer
409080099MedicaidME

Other names 1

  • Mrs. Christine D Blake Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040723000949 ME Practitioner - Family Practice 9537149083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New England, College of Osteo Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

114 Stroudwater St
Westbrook, ME 04092-4037
Phone (207) 856-6792

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO2350MEMDNeuromusculoskeletal Medicine & OMM Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Opioid Dependency Program Addiction Medicine CurrentSince May 12, 2024 Accepting new patients

Locations

114 Stroudwater St
Westbrook, ME 04092
Phone (207) 405-1474

Interoperability endpoints

  • Direct secure messaging: christine.blake.1@3432.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 39

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1760531180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 STROUDWATER ST",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040924037",
            "telephone_number": "207-856-6792",
            "fax_number": "207-854-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 STROUDWATER ST",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040924037",
            "telephone_number": "207-856-6792",
            "fax_number": "207-854-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CHRISTINE",
        "middle_name": "BLAKE",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ME",
            "license": "DO2350",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO2350",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "ME",
            "license": "DO2350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "409080099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "BLAKE",
            "middle_name": "D",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westbrook, ME

Sources for this page

Verify at the official NPI Registry.