NPIMap

Organization Active NPI

Storeysmith Pediatric Clinic

  • Speech-Language Pathologist
  • Falmouth, ME
National Provider Identifier
1760600803
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP667 Issued in ME
Legal business name
STOREYSMITH PEDIATRIC CLINIC
Practice address
170 US Route 1 Ste 100
Falmouth, ME 04105-2152
Phone
(207) 781-0022
Fax
(207) 781-0025
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Authorized official

Name
Jaime S KiesowNPI 1659424380
Title
Ceo
Phone
(207) 781-0022

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X SP667 ME Primary

Addresses

Primary practice location

170 US Route 1 Ste 100
Falmouth, ME 04105-2152

Mailing address

170 US Route 1 Ste 100
Falmouth, ME 04105-2152
Phone (207) 781-0022

Other identifiers 1

IdentifierTypeStateIssuer
23494099MedicaidME

National Provider Directory

National Provider Directory
Tax ID family
Storey Smith Pediatric Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784073600000",
    "number": "1760600803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 US ROUTE 1 STE 100",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041052152",
            "telephone_number": "207-781-0022",
            "fax_number": "207-781-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 US ROUTE 1 STE 100",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041052152",
            "telephone_number": "207-781-0022",
            "fax_number": "207-781-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOREYSMITH PEDIATRIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "KIESOW",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-781-0022"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23494099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falmouth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.