Individual provider Active NPI

James Stevenson, PT

  • Physical Therapist
  • Waterboro, ME
National Provider Identifier
1962430827
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1854 Issued in ME
Practice address
392 Main St
Waterboro, ME 04087-3057
Phone
(207) 247-3216
Fax
(207) 247-3217
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1854 ME Primary

Addresses

Primary practice location

392 Main St
Waterboro, ME 04087-3057

Mailing address

PO Box 456
Waterboro, ME 04087-0456
Phone (207) 247-3216

Other identifiers 1

IdentifierTypeStateIssuer
ANTHEMOtherME024807

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050725001203 ME Practitioner - Physical Therapist in Private Practice 5193792935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Physical Therapy P.a.Group PAC ID 4486686045, 4 clinicians
Massabesic Health Resources PAGroup PAC ID 5395712137, 12 clinicians

Practice addresses (Care Compare)

16 Old Pike Rd
Cornish, ME 04020-3506
Phone (207) 625-4300

16 Old Pike Rd
PO Box 48
Cornish, ME 04020-0048

392 Main St
Waterboro, ME 04087-3057
Phone (207) 247-3216

PO Box
Suite 48
Cornish, ME 04020-0048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1962430827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 456",
            "city": "WATERBORO",
            "state": "ME",
            "postal_code": "040870456",
            "telephone_number": "207-247-3216",
            "fax_number": "207-247-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "392 MAIN ST",
            "city": "WATERBORO",
            "state": "ME",
            "postal_code": "040873057",
            "telephone_number": "207-247-3216",
            "fax_number": "207-247-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "JAMES",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT1854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "024807",
            "identifier": "ANTHEM",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterboro, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.