NPIMap

Organization Active NPI

Northern Maine General

Doing business as Northern Aquatics

  • Physical Therapist
  • Eagle Lake, ME
National Provider Identifier
1831211507
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NORTHERN MAINE GENERAL
Doing business as
Northern Aquatics
Practice address
37 Carter Street
Eagle Lake, ME 04739-0310
Phone
(207) 444-5152
NPI assigned
Apr 4, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Reynold Raymond
Title
Ceo
Phone
(207) 444-5152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

37 Carter Street
Eagle Lake, ME 04739-0310

Mailing address

PO Box 310
Eagle Lake, ME 04739-0310
Phone (207) 444-5152

Other names 1

  • Northern Aquatics Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831211507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310",
            "city": "EAGLE LAKE",
            "state": "ME",
            "postal_code": "047390310",
            "telephone_number": "207-444-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 CARTER STREET",
            "city": "EAGLE LAKE",
            "state": "ME",
            "postal_code": "047390310",
            "telephone_number": "207-444-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MAINE GENERAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "REYNOLD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-444-5152"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Aquatics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle Lake, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.