Organization Active NPI

Dr. Bert J. Daigle C.C.S.P,,P.a.

  • Chiropractor
  • Lewiston, ME
National Provider Identifier
1790942654
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DR. BERT J. DAIGLE C.C.S.P,,P.A.
Practice address
1008 Lisbon St
Lewiston, ME 04240-5721
Phone
(207) 784-2049
Fax
(207) 784-8562
NPI assigned
May 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Dr. Berthol J Daigle, D.C.
Title
President
Phone
(207) 784-2049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1008 Lisbon St
Lewiston, ME 04240-5721

Mailing address

1008 Lisbon St
Lewiston, ME 04240-5721
Phone (207) 784-2049

Other identifiers 1

IdentifierTypeStateIssuer
017363OtherMEANTHEM

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1790942654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 LISBON ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405721",
            "telephone_number": "207-784-2049",
            "fax_number": "207-784-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 LISBON ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405721",
            "telephone_number": "207-784-2049",
            "fax_number": "207-784-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BERT J. DAIGLE C.C.S.P,,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "DAIGLE",
        "authorized_official_first_name": "BERTHOL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-784-2049",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "017363",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.