Pine Tree Wholistic Health

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

PINE TREE WHOLISTIC HEALTH

Practice address

336 Mount Hope Ave
Suite 11
Bangor, ME 04401-4236

Phone

(207) 942-2800

NPI assigned

Feb 11, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Thomas J Vanidestine Jr., DC,CCSPNPI 1538108022

Title

President

Phone

(207) 942-2800

Specialties & licenses 1

Addresses

Practitioners 1

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

• Thomas J Vanidestine Jr., DC, CCSP

  • Chiropractor
  • Bangor, ME
  • NPI 1538108022
  NPD (past) Authorized official

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1922467596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 MOUNT HOPE AVE",
            "address_2": "SUITE 11",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014236",
            "telephone_number": "207-942-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 MOUNT HOPE AVE",
            "address_2": "SUITE 11",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014236",
            "telephone_number": "207-942-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE TREE WHOLISTIC HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "VANIDESTINE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-942-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DC,CCSP"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia R Picone, MD
• Abigail Hamel Pierce, LCSW, CADC
• Jolene Pierce, RDH, IPDH
• Pine Tree Physical Therapy, Inc.
• Pine Tree Urgent Care LLC
• Pinecrest Haven
• Shannon C Piner, FNP
• Pinetree Behavioral Health, LLC
• Karen Pinkham, DPT
• Lindsey M Piper

• Interventional Pain Medicine Physician in Bangor, ME
• Providers in Bangor, ME by specialty
• Interventional Pain Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.