Individual provider Active NPI

Jason Horr, NNP

  • Critical Care Neonatal Nurse Practitioner
  • Bangor, ME
National Provider Identifier
1770988453
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
CNP141094 Issued in ME
Practice address
489 State St
Kelley 6
Bangor, ME 04401-6616
Phone
(207) 973-8670
NPI assigned
Oct 24, 2014
Last updated
Oct 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X CNP141094 ME Primary

Addresses

Primary practice location

489 State St
Kelley 6
Bangor, ME 04401-6616

Mailing address

489 State St
Kelley 6
Bangor, ME 04401-6616
Phone (207) 973-8670

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20141216001885 ME Practitioner - Nurse Practitioner 7911220363 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP141094MEMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Oct 19, 2014 Accepting new patients
Eastern Maine Medical Center CurrentSince Oct 19, 2014 Accepting new patients

Locations

489 State St
#6
Bangor, ME 04401
Phone (207) 973-6676

489 State St
Bangor, ME 04401
Phone (207) 973-8837

489 State St
Ste 6
Bangor, ME 04401

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.

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1770988453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "address_2": "KELLEY 6",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "address_2": "KELLEY 6",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORR",
        "first_name": "JASON",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "ME",
            "license": "CNP141094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.