NPIMap

Organization Active NPI

Convenientmd LLC

  • Family Medicine Physician
  • Bangor, ME
National Provider Identifier
1881401552
Registry record updated Jan 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CONVENIENTMD LLC
Practice address
689 Broadway
Bangor, ME 04401-3366
Phone
(207) 744-8424
Fax
(207) 744-8425
NPI assigned
Dec 16, 2024
Organization subpart
Yes
Parent organization
CONVENIENTMD LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 15, 2026

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

Authorized official

Name
Rachel Castellez-Davidson
Title
Medical Staffing Lead
Phone
(603) 410-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

689 Broadway
Bangor, ME 04401-3366

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180220000535 ME Part B Supplier - Clinic/Group Practice 2062667033 Receives reassigned benefits from 9 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ellsworth, ME; Saco, ME; Sanford, ME; Westbrook, ME; Portland, ME; Bangor, ME; Augusta, ME; Auburn, ME…

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Convenientmd LLC29 organizations share this tax ID, including this one
Part of
Convenientmd LLC

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

29 Storey Ave
Newburyport, MA 01950
Phone (978) 225-6607

421 Andover St
North Andover, MA 01845
Phone (978) 620-5040

590 Center St
Auburn, ME 04210
Phone (207) 955-5565

687 Broadway
Bangor, ME 04401
Phone (207) 744-8424

689 Broadway
Bangor, ME 04401
Phone (207) 444-8424

21 Hampton Rd
Bldg 2
Exeter, NH 03833
Phone (603) 519-3092

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768435200000",
    "number": "1881401552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-309-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013366",
            "telephone_number": "207-744-8424",
            "fax_number": "207-744-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENTMD LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CONVENIENTMD LLC",
        "enumeration_date": "2024-12-16",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A",
        "authorized_official_last_name": "CASTELLEZ-DAVIDSON",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "MEDICAL STAFFING LEAD",
        "authorized_official_telephone_number": "603-410-6700"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; 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.