Mainehealth

Primary specialty

Psychiatric Hospital UnitTaxonomy code 273R00000X

License

37915 Issued in ME

Legal business name

MAINEHEALTH

Doing business as

Southern Maine Health Care

Practice address

1 Medical Center Dr
Biddeford, ME 04005-9422

Phone

(207) 283-7000

Fax

(207) 283-7020

NPI assigned

Jul 26, 2006

Last updated

May 11, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

MAINEHEALTHAs reported in NPPES

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

Authorized official

Name

Lugene Anthony Inzana

Title

Cfo & Associate Cfo

Phone

(207) 662-3538

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southern Maine Health Care Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831112952. Details of each certification follow.

• CCN 200019 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 200019

Legal name

SOUTHERN MAINE HEALTH CARE

Certification status

Terminated Voluntary: merger or closure, May 31, 2024

Provider type (POS)

Hospital – Short-term

Participating since

May 26, 1969

Last certification

Nov 10, 2016

Beds

150

Ownership / control type

Private (not for profit)

Most recent change of ownership

Jan 1, 2019 (4 total)

Facility address

1 Medical Center Drive
Biddeford, ME 04005

Part of

Mainehealth

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1831112952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 626",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040050626",
            "telephone_number": "207-283-7000",
            "fax_number": "207-283-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059422",
            "telephone_number": "207-283-7000",
            "fax_number": "207-283-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINEHEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAINEHEALTH",
        "enumeration_date": "2006-07-26",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "INZANA",
        "authorized_official_first_name": "LUGENE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CFO & ASSOCIATE CFO",
        "authorized_official_telephone_number": "207-662-3538"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "ME",
            "license": "37915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101580000",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Southern Maine Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maine Periodontics Plllc
• Mainehealth (Mainehealth Behavioral Health)
• Mainehealth (SMHC Physician Services)
• Mainehealth (Counseling Services, Inc.)
• Mainehealth (MaineHealth Pharmacy Maine Medical Center Biddeford)
• Mainehealth (Mainehealth Pharmacy Maine Medical Center Biddeford)
• Vani Mallipeddi, DMD
• Malon Chiropractic Centre
• Malon Chiropractic Centre LLC
• Marc G Malon, D.C.

• Psychiatric Hospital Unit in Biddeford, ME
• Providers in Biddeford, ME by specialty
• Psychiatric Hospital Unit in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.