Waterville Pediatrics PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

1317 Issued in ME

Legal business name

WATERVILLE PEDIATRICS PA

Practice address

295C Kennedy Memorial Dr
Waterville, ME 04901-4535

Phone

(207) 873-5437

Fax

(207) 872-6037

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Jeffrey Stone, D.O.NPI 1891799649

Title

Treasurer

Phone

(207) 873-5437

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lorien C Batt, MD

  • Pediatrics Physician
  • Waterville, ME
  • NPI 1063402733
  Medicare reassignment NPD
• Matthew Christopher Mason, DO

  • Pediatrics Physician
  • Waterville, ME
  • NPI 1659878254
  Medicare reassignment NPD
• Shelby Mast, DO

  • Pediatrics Physician
  • Skowhegan, ME
  • NPI 1851898456
  Medicare reassignment NPD
• Allison Scully, CNP

  • Family Nurse Practitioner
  • Waterville, ME
  • NPI 1568056851
  Medicare reassignment NPD
• Jeffrey A Stone, D.O.

  • Pediatrics Physician
  • Waterville, ME
  • NPI 1891799649
  NPD (past) Authorized official
• Anderson Elizabeth Clement, FNP-C

  • Family Nurse Practitioner
  • Waterville, ME
  • NPI 1326874280
  NPD
• John C Hickey, M.D.

  • Pediatrics Physician
  • Waterville, ME
  • NPI 1902837701
  NPD
• Melissa D Taylor, D.O.

  • Pediatrics Physician
  • Waterville, ME
  • NPI 1497759187
  NPD
• Amelia Brochu, P.A.-C.

  • Pediatrics Physician
  • Waterville, ME
  • NPI 1699852715
  NPD (past)
• Charles E Danielson, M.D.

  • Pediatrics Physician
  • Waterville, ME
  • NPI 1073517819
  NPD (past)
• Nicole M Donahue, CPNP

  • Pediatric Nurse Practitioner
  • Waterville, ME
  • NPI 1336490804
  NPD (past)
• Leslie D Doolittle, M.D.

  • Pediatrics Physician
  • Waterville, ME
  • NPI 1861496606
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617321600000",
    "number": "1790871994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295C KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014535",
            "telephone_number": "207-873-5437",
            "fax_number": "207-872-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295C KENNEDY MEMORIAL DR",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014535",
            "telephone_number": "207-873-5437",
            "fax_number": "207-872-6037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "159 Silver St",
            "address_purpose": "LOCATION",
            "city": "Waterville",
            "state": "ME",
            "postal_code": "049015813",
            "country_code": "US",
            "telephone_number": "207-873-5437",
            "fax_number": "207-872-6037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WATERVILLE PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A",
        "authorized_official_last_name": "STONE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "207-873-5437",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "ME",
            "license": "1317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000206014",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINECARE PROVIDER NO.",
            "identifier": "129440000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Waterville Center for Health and Rehab LLC
• Waterville Family Practice
• Waterville Home Oxygen, LLC
• Waterville Medical Supplies
• Waterville OB/GYN, PA
• Waterville Pharmacy
• Waterville Pharmacy
• Waterville Public Schools
• Waterville Public Schools
• Waterville Public Schools

• Pediatrics Physician in Waterville, ME
• Providers in Waterville, ME by specialty
• Pediatrics Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.