Individual provider Active NPI

Elwood J Fox, DO

  • Physical Medicine & Rehabilitation Physician
  • Westbrook, ME
National Provider Identifier
1770530404
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
1709 Issued in ME
Practice address
2 Chabot St
Westbrook, ME 04092-4817
Phone
(207) 857-9311
Fax
(207) 857-9473
NPI assigned
May 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1709 ME
Internal Medicine Physician 207R00000X 152398 MA
Physical Medicine & Rehabilitation Physician 208100000X 152398 MA
Physical Medicine & Rehabilitation Physician 208100000X 3552 TN
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 1709 ME
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 1709 ME
Physical Medicine & Rehabilitation Physician 208100000X 1709 ME Primary

Addresses

Primary practice location

2 Chabot St
Westbrook, ME 04092-4817

Mailing address

59 Sleepy Hollow Dr
Gorham, ME 04038-2563
Phone (207) 857-9311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
152398MAMDInternal Medicine Physician
3552TNMDPhysical Medicine & Rehabilitation Physician
1709MEMDSports Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kennebunk Operations, LLC Past Accepting new patients
Southern Maine in Home Therapy Services,LLC PastSince Jun 2, 2013 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1770530404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 SLEEPY HOLLOW DR",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040382563",
            "telephone_number": "207-857-9311",
            "fax_number": "207-857-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHABOT ST",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040924817",
            "telephone_number": "207-857-9311",
            "fax_number": "207-857-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "ELWOOD",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ME",
            "license": "1709",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "152398",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "152398",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "3552",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "ME",
            "license": "1709",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "ME",
            "license": "1709",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ME",
            "license": "1709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; 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.