NPIMap

Organization Active NPI

Penobscot Nation Health Department

  • Clinic/Center
  • Indian Island, ME
National Provider Identifier
1801101993
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
12011471A Issued in IN
Legal business name
PENOBSCOT NATION HEALTH DEPARTMENT
Practice address
23 Wabanaki Way
Indian Island, ME 04468-1252
Phone
(207) 817-7400
Fax
(207) 817-7459
NPI assigned
Aug 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

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

Authorized official

Name
Jill P Macdougall
Title
Intern Director
Phone
(207) 817-7404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 12011471A IN Primary

Addresses

Primary practice location

23 Wabanaki Way
Indian Island, ME 04468-1252

Mailing address

23 Wabanaki Way
Indian Island, ME 04468-1252
Phone (207) 817-7400

National Provider Directory

National Provider Directory
Tax ID family
Penobscot Indian Nation Finance Office3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281571200000",
    "number": "1801101993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 WABANAKI WAY",
            "city": "INDIAN ISLAND",
            "state": "ME",
            "postal_code": "044681252",
            "telephone_number": "207-817-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 WABANAKI WAY",
            "city": "INDIAN ISLAND",
            "state": "ME",
            "postal_code": "044681252",
            "telephone_number": "207-817-7400",
            "fax_number": "207-817-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENOBSCOT NATION HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-08-12",
        "status": "A",
        "authorized_official_last_name": "MACDOUGALL",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "INTERN DIRECTOR",
        "authorized_official_telephone_number": "207-817-7404"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IN",
            "license": "12011471A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Island, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.