Active NPI
Cynthia L Nulton, AUD
- Audiologist
- Bangor, ME
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AP3991
- Practice address
- 6 Telcom Dr
Bangor, ME 04401-3072 - Phone
- (207) 941-2850
- NPI assigned
- Jun 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | A469 | NH | |
| Audiologist | 231H00000X | AP3991 | ME | Primary |
Addresses
Primary practice location
6 Telcom Dr
Bangor, ME 04401-3072
Mailing address
PO Box 1599
Bangor, ME 04402-1599
Other practice location 1
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-8123
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30432224 | Medicaid | NH | |
| 1009205 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230824004012 | ME | Practitioner - Qualified Audiologist | 4082888219 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6 Telcom Dr
Bangor, ME 04401-3072
Phone (207) 941-2850
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP3991 | ME | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penobscot Community Health Center | Current | Accepting new patients | |
| Penobscot Community Health Center | Current | Accepting new patients | |
| Penobscot Community Health Center | Past | Accepting new patients |
Locations
6 Telcom Dr
Bangor, ME 04401
Phone (207) 941-2850
1012 Union St
Ste 1
Bangor, ME 04401
Phone 2079455247407
1012 Union St
Ste 3
Bangor, ME 04401
Phone (207) 404-8040
6 Telcom Dr
Fl 1
Bangor, ME 04401
Phone (207) 941-2850
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.
-
- Federally Qualified Health Center (FQHC)
- Bangor, ME
- NPI 1427169010
ME
-
- Federally Qualified Health Center (FQHC)
- Bangor, ME
- NPI 1083259410
-
- Hearing and Speech Clinic/Center
- Bangor, ME
- NPI 1285685628
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696291200000",
"number": "1790712396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1599",
"city": "BANGOR",
"state": "ME",
"postal_code": "044021599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 TELCOM DR",
"city": "BANGOR",
"state": "ME",
"postal_code": "044013072",
"telephone_number": "207-941-2850"
}
],
"practiceLocations": [
{
"address_1": "1 Medical Center Dr",
"address_purpose": "LOCATION",
"city": "Lebanon",
"state": "NH",
"postal_code": "037561000",
"country_code": "US",
"telephone_number": "603-650-8123",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NULTON",
"first_name": "CYNTHIA",
"middle_name": "L",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2023-10-03",
"certification_date": "2023-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NH",
"license": "A469",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "ME",
"license": "AP3991",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30432224",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1009205",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bangor, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.