Individual provider Active NPI

Lorraine L Lick, FNPC

  • Family Nurse Practitioner
  • Old Town, ME
National Provider Identifier
1871870816
Registry record updated May 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP161151 Issued in ME
Practice address
242 Brunswick St
Old Town, ME 04468-1613
Phone
(207) 827-6128
NPI assigned
Nov 4, 2011
Last updated
May 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP161151 ME Primary

Addresses

Primary practice location

242 Brunswick St
Old Town, ME 04468-1613

Mailing address

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

Other practice location 1

1365 Broadway
Bangor, ME 04401
Phone (207) 942-6226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211202000437 AZ Practitioner - Nurse Practitioner 3779745138 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner Urgent Care Services LLCGroup PAC ID 4284921610, 207 clinicians

Practice addresses (Care Compare)

10330 N Scottsdale Rd
Suite 25
Scottsdale, AZ 85253-1427
Phone (602) 255-7625

11685 W Van Buren St
Avondale, AZ 85323-6904
Phone (623) 465-6420

13901 W Meeker Blvd
Sun City West, AZ 85375-4475
Phone (623) 465-6435

15223 N 87TH St
Suite 110
Scottsdale, AZ 85260-2640
Phone (480) 682-4100

15521 W Bell Rd
Surprise, AZ 85374-3437
Phone (623) 465-6390

7611 W Cactus Rd
Peoria, AZ 85381-5203
Phone (623) 465-6315

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP161151MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Urgent Care Arizona LLC CurrentSince Jan 1, 2022 Accepting new patients
Banner Urgent Care Arizona LLC CurrentSince Jan 1, 2022 Accepting new patients
Banner Urgent Care Services, LLC CurrentSince Jan 1, 2022 Accepting new patients
Banner Urgent Care Services, LLC CurrentSince Jan 1, 2022 Accepting new patients
Banner Urgent Care Services, LLC Current Accepting new patients

Locations

11685 W Van Buren St
Avondale, AZ 85323
Phone (623) 465-6420

1676 E McMurray Blvd
Ste 1
Casa Grande, AZ 85122
Phone (520) 316-0688

16430 W Yuma Rd
Goodyear, AZ 85338
Phone (623) 465-6405

3328 N Litchfield Rd
Goodyear, AZ 85395
Phone (623) 239-0394

3457 W White Mountain Blvd
Lakeside, AZ 85929
Phone (888) 264-2127

1121 S Gilbert Rd
Ste 101
Mesa, AZ 85204
Phone (480) 644-9355

101 E State Highway 260
Ste G
Payson, AZ 85541
Phone (888) 264-2127

35945 N Gary Rd
San Tan Valley, AZ 85143
Phone (480) 827-5750

10330 N Scottsdale Rd
Ste 25
Scottsdale, AZ 85253
Phone (602) 255-7625

680 E Deuce of Clubs
Ste B
Show Low, AZ 85901
Phone (928) 537-2777

7066 E Golf Links Rd
Tucson, AZ 85730
Phone (520) 514-0344

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1871870816",
    "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": "242 BRUNSWICK ST",
            "city": "OLD TOWN",
            "state": "ME",
            "postal_code": "044681613",
            "telephone_number": "207-827-6128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1365 Broadway",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "04401",
            "country_code": "US",
            "telephone_number": "207-942-6226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICK",
        "first_name": "LORRAINE",
        "middle_name": "L",
        "credential": "FNPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-04",
        "last_updated": "2021-05-05",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP161151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Town, ME

Sources for this page

Verify at the official NPI Registry.