Active NPI
Christy A Rousseau, MS PA C
- Physician Assistant
- Damariscotta, ME
National Provider Identifier
1790769032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA-583
- Practice address
- 35 Miles St
Miles Medical Group Emergency Dept
Damariscotta, ME 04543-4047 - Phone
- (207) 563-4521
- Fax
- (207) 563-3717
- NPI assigned
- Nov 30, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-583 | ME | Primary |
Addresses
Primary practice location
35 Miles St
Miles Medical Group Emergency Dept
Damariscotta, ME 04543-4047
Mailing address
35 Miles St
Miles Medical Group Emergency Dept
Damariscotta, ME 04543-4047
Phone (207) 563-4521
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-583 | ME | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790769032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 MILES ST",
"address_2": "MILES MEDICAL GROUP EMERGENCY DEPT",
"city": "DAMARISCOTTA",
"state": "ME",
"postal_code": "045434047",
"telephone_number": "207-563-4521",
"fax_number": "207-563-3717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 MILES ST",
"address_2": "MILES MEDICAL GROUP EMERGENCY DEPT",
"city": "DAMARISCOTTA",
"state": "ME",
"postal_code": "045434047",
"telephone_number": "207-563-4521",
"fax_number": "207-563-3717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUSSEAU",
"first_name": "CHRISTY",
"middle_name": "A",
"credential": "MS PA C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ME",
"license": "PA-583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Damariscotta, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.