Organization Active NPI

Light of Life Ministries Inc

Doing business as Advanced Health Physical Therapy

  • Physical Therapist
  • Augusta, ME
National Provider Identifier
1841289345
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LIGHT OF LIFE MINISTRIES INC
Doing business as
Advanced Health Physical Therapy
Practice address
160 Riverside Dr
Augusta, ME 04330-4162
Phone
(207) 622-9467
Fax
(207) 623-2874
NPI assigned
Oct 18, 2005
Last updated
Jul 31, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Authorized official

Name
Mrs. Jane E Chapman
Title
Administrator
Phone
(207) 622-9467

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

160 Riverside Dr
Augusta, ME 04330-4162

Mailing address

160 Riverside Dr
Augusta, ME 04330-4162
Phone (207) 622-9467

Other identifiers 1

IdentifierTypeStateIssuer
410460000MedicaidME

Other names 1

  • Advanced Health Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040406000321 ME Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0143213108 Receives reassigned benefits from 4 practitioners
Practice locations: Augusta, ME; Waterville, ME

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1841289345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 RIVERSIDE DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043304162",
            "telephone_number": "207-622-9467",
            "fax_number": "207-623-2874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 RIVERSIDE DR",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043304162",
            "telephone_number": "207-622-9467",
            "fax_number": "207-623-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT OF LIFE MINISTRIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "207-622-9467",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410460000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Health Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.