Clover Manor Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CLOVER MANOR INC

Practice address

440 Minot Ave
Auburn, ME 04210-4332

Phone

(207) 784-3573

NPI assigned

Nov 4, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Sheryl A Bradley

Title

Chief Financial Officer

Phone

(207) 782-4797

Specialties & licenses 1

Addresses

Other identifiers 4

Practitioners 2

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

• Thomas C Hattan, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Lewiston, ME
  • NPI 1598708315
  NPD (past)
• Andrei Zaslavsky, DO

  • Internal Medicine Physician
  • Portland, ME
  • NPI 1922365683
  NPD (past)

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1942291281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 GODDARD RD",
            "address_2": "SUITE A",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042401000",
            "telephone_number": "207-782-4797",
            "fax_number": "207-777-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 MINOT AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042104332",
            "telephone_number": "207-784-3573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVER MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-04",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "207-782-4797",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106170100",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106170000",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106170002",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106170001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth W Clark, PT
• Kaitlin Elaine Clark
• Kara Clark, NP
• Stephen P Clark, M.D.
• Christine Cloutier, SLP
• Coastal Med Tech, Inc.
• Rebecca Cobb, MSPT
• Nicole Cochran, OTR/L
• Kylee Susan Cole, MOT, OT/L
• Noreen Comeau, NP-C

• Skilled Nursing Facility in Auburn, ME
• Providers in Auburn, ME by specialty
• Skilled Nursing Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.