Kathleen A Pike, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP211516 Issued in ME

Practice address

242 Brunswick St
Old Town, ME 04468-1613

Phone

(207) 827-6128

Fax

(207) 827-6605

NPI assigned

Sep 30, 2021

Last updated

Oct 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Penobscot Community Health CenterGroup PAC ID 0143212670, 135 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Penobscot Community Health Center

  dba Penobscot Community Health Care

  • Federally Qualified Health Center (FQHC)
  • Bangor, ME
  • NPI 1427169010
  Medicare reassignment Care Compare group NPD
• Penobscot Community Health Center

  dba Adult Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Bangor, ME
  • NPI 1083259410
  NPD

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1891467601",
    "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",
            "fax_number": "207-827-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIKE",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP211516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Penobscot Community Health Center (Old Town Elementary School RSU 34)
• Penobscot Community Health Center (Old Town High School RSU 34)
• Penobscot Community Health Center (Helen Hunt Health Center)
• Penobscot Community Health Center (J.A. Leonard Middle School RSU 34)
• Stanley O Pettegrow, LCSW
• Katarina Prokopova, MD
• Regional School Unit #34
• Christine Ann Crittenden Richard, LCSW
• Emma April Richford
• Joshua Richie, PMHNP

• Psychiatric/Mental Health Nurse Practitioner in Old Town, ME
• Providers in Old Town, ME by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.