Individual provider Active NPI

Catherine Gallagher Gaynor, FNP-C

  • Family Nurse Practitioner
  • Portland, ME
National Provider Identifier
1790994036
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP081773 Issued in ME
Practice address
180 Park Ave Ste 1
Portland, ME 04102-2927
Phone
(207) 874-2141
Fax
(207) 874-2164
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP081773 ME Primary

Addresses

Primary practice location

180 Park Ave Ste 1
Portland, ME 04102-2927

Mailing address

180 Park Ave
Portland, ME 04102-2957
Phone (207) 874-2141

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
I20150123000746 ME Practitioner - Nurse Practitioner 5890019731 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP081773MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Community Health Center CurrentSince Dec 15, 2014 Accepting new patients
Portland Community Health Center CurrentSince Dec 15, 2014 Accepting new patients

Locations

180 Park Ave
Portland, ME 04102
Phone (207) 772-3703

59 Riverton Dr
Portland, ME 04103

180 Park Ave
Ste 1
Portland, ME 04102
Phone (207) 828-2101

Interoperability endpoints

  • Direct secure messaging: catherine.gaynor.p1@direct.portlandchc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1790994036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PARK AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022957",
            "telephone_number": "207-874-2141",
            "fax_number": "207-874-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 PARK AVE STE 1",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022927",
            "telephone_number": "207-874-2141",
            "fax_number": "207-874-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYNOR",
        "first_name": "CATHERINE",
        "middle_name": "GALLAGHER",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "AP081773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.