NPIMap

Individual provider Active NPI

Robbin J League, FNPC

  • Nurse Practitioner
  • Winterport, ME
National Provider Identifier
1801418199
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP201184 Issued in ME
Practice address
775 N Main St
Winterport, ME 04496-3414
Phone
(207) 223-0965
Fax
(207) 223-0975
NPI assigned
May 11, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penobscot Community Health Center 135 clinicians

Practice addresses (Care Compare)

1012 Union St
Suite 1
Bangor, ME 04401-3058
Phone (207) 404-8100

Hospital & facility affiliations

  • St Joseph Hospital Hospital, Bangor, ME, CCN 200001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200720000088 ME Practitioner - Nurse Practitioner 2466876891 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP201184MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Penobscot Community Health Center CurrentSince Jun 19, 2020 Accepting new patients
Penobscot Community Health Center CurrentSince Jun 19, 2020 Accepting new patients
Intentional Healthcare, LLC Nurse Practitioner Current Accepting new patients
Penobscot Community Health Center Past Accepting new patients

Locations

1068 Union St
Bangor, ME 04401
Phone (207) 404-8181

1012 Union St
Bangor, ME 04401
Phone (207) 404-8200

1012 Union St
Ste 1
Bangor, ME 04401
Phone 2079455247407

735 Wilson St
Brewer, ME 04412
Phone (207) 989-1567

775 N Main St
Winterport, ME 04496
Phone (207) 223-0965

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP201184 ME Primary

Addresses

NPPES NPI Registry

Primary practice location

775 N Main St
Winterport, ME 04496-3414

Mailing address

PO Box 1599
Bangor, ME 04402-1599
Phone (207) 404-8200

Other practice location 1

1068 Union St
Bangor, ME 04401-3016
Phone (207) 404-8181

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 5, 2021.

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1801418199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-404-8200",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 N MAIN ST",
            "city": "WINTERPORT",
            "state": "ME",
            "postal_code": "044963414",
            "telephone_number": "207-223-0965",
            "fax_number": "207-223-0975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1068 Union St",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044013016",
            "country_code": "US",
            "telephone_number": "207-404-8181",
            "fax_number": "207-922-4198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEAGUE",
        "first_name": "ROBBIN",
        "middle_name": "J",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP201184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winterport, ME

Sources for this page

Verify at the official NPI Registry.