NPIMap

Organization Active NPI

Webber Hospital Association

Doing business as SMMC Pediatrics Biddeford

  • Pediatrics Physician
  • Biddeford, ME
National Provider Identifier
1942403266
Registry record updated Oct 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
WEBBER HOSPITAL ASSOCIATION
Doing business as
SMMC Pediatrics Biddeford
Practice address
473 Alfred St
Biddeford, ME 04005-9447
Phone
(207) 283-9031
Fax
(207) 284-9825
NPI assigned
Jun 6, 2007
Last updated
Oct 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2008

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

Authorized official

Name
Frank Lavoie, MD
Title
VP Medical Affairs
Phone
(207) 283-7000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X NU
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

473 Alfred St
Biddeford, ME 04005-9447

Mailing address

39 Wallace Ave
South Portland, ME 04106-6143
Phone (207) 761-0650

Other identifiers 3

IdentifierTypeStateIssuer
101580000MedicaidME
30216388MedicaidNH
432732800MedicaidME

Other names 1

  • SMMC Pediatrics Biddeford Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040713001060 ME Part B Supplier - Clinic/Group Practice 0143208348 Receives reassigned benefits from 292 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sanford, ME; Saco, ME; Biddeford, ME; North Berwick, ME; Kennebunk, ME; East Waterboro, ME

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225065600000",
    "number": "1942403266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WALLACE AVE",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041066143",
            "telephone_number": "207-761-0650",
            "fax_number": "207-761-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 ALFRED ST",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059447",
            "telephone_number": "207-283-9031",
            "fax_number": "207-284-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEBBER HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2008-10-27",
        "status": "A",
        "authorized_official_last_name": "LAVOIE",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "VP MEDICAL AFFAIRS",
        "authorized_official_telephone_number": "207-283-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101580000",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30216388",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432732800",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMMC Pediatrics Biddeford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Biddeford, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2008; 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.