Roderick A Forrey, PA-C
Individual provider Active NPI Physician Assistant · Fairfield, ME
NPI 1881662047 · NPPES record last updated Jul 3, 2008
Key facts
- NPI
- 1881662047
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA-315 (ME)
- Practice address
- 4 Sheridan Rd
Fairfield, ME 04937-3314 - Phone
- (207) 861-5000
- Fax
- (207) 861-5001
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-315 | ME | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mainegeneral Medical Center | Past | Accepting new patients | |
| Mainegeneral Medical Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-315 | ME | Yes |
Addresses
Primary practice location
4 Sheridan Rd
Fairfield, ME 04937-3314
Mailing address
4 Sheridan Rd
Fairfield, ME 04937-3314
Phone (207) 861-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 320120099 | Medicaid | ME |
Other providers in Fairfield, ME
- Eastern Maine Homecare
- Eastern Maine Homecare
- El Rancho de la Vida
- Fairfield Family Practice
- Fairfield Pharmacy
- Tania Coy Gardiner Hassard
- Jessy Matthew Garrett
- Jennifer L Giroux
- Tracey S Glinko
- Kelsey Jean Gwazdosky
All providers in Fairfield, ME · Physician Assistant in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.