NPIMap

Organization Active NPI

Penobscot Community Health Center

Doing business as J.A. Leonard Middle School RSU 34

  • General Practice Physician
  • Old Town, ME
National Provider Identifier
1962276022
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
PENOBSCOT COMMUNITY HEALTH CENTER
Doing business as
J.A. Leonard Middle School RSU 34
Practice address
156 Oak St
Old Town, ME 04468-1681
Phone
(207) 404-8000
NPI assigned
Nov 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Authorized official

Name
Lorelle Dwyer, ESQ.
Title
President & Ceo
Phone
(207) 992-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

156 Oak St
Old Town, ME 04468-1681

Mailing address

PO Box 1599
Bangor, ME 04402-1599
Phone (207) 992-2456

Other names 1

  • J.A. Leonard Middle School RSU 34 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
PCHC Physical Therapy and Balance Center40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Locations

576 Stillwater Ave
Old Town, ME 04468
Phone (207) 404-8000

Practitioners & affiliated clinicians

Practitioners 1

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": "1699488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1962276022",
    "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": "207-992-2456",
            "fax_number": "207-992-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 OAK ST",
            "city": "OLD TOWN",
            "state": "ME",
            "postal_code": "044681681",
            "telephone_number": "207-404-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENOBSCOT COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "DWYER",
        "authorized_official_first_name": "LORELLE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "207-992-9200",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J.A. Leonard Middle School RSU 34",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Old Town, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.