NPIMap

Organization Active NPI

Wotton Waiver Home

  • In Home Supportive Care Agency
  • Monticello, ME
National Provider Identifier
1811121817
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
WOTTON WAIVER HOME
Practice address
232 Wotton Road
Monticello, ME 04760-0125
Phone
(207) 538-9652
NPI assigned
May 6, 2009
Last updated
May 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Authorized official

Name
Mrs. Bonnie M Wotton
Title
Waiver Home Provider
Phone
(207) 538-9652

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

232 Wotton Road
Monticello, ME 04760-0125

Mailing address

PO Box 125
Monticello, ME 04760-0125
Phone (207) 538-9652

Other identifiers 1

IdentifierTypeStateIssuer
196370000MedicaidME

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1811121817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "MONTICELLO",
            "state": "ME",
            "postal_code": "047600125",
            "telephone_number": "207-538-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 WOTTON ROAD",
            "city": "MONTICELLO",
            "state": "ME",
            "postal_code": "047600125",
            "telephone_number": "207-538-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOTTON WAIVER HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-06",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "WOTTON",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "WAIVER HOME PROVIDER",
        "authorized_official_telephone_number": "207-538-9652",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196370000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.