NPIMap

Organization Active NPI

Mainehealth

  • Rural Health Clinic/Center
  • Waldoboro, ME
National Provider Identifier
1962573337
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MAINEHEALTH
Practice address
126 Depot St
Waldoboro, ME 04572-5913
Phone
(207) 832-6394
Fax
(207) 832-4392
NPI assigned
Nov 10, 2006
Organization subpart
Yes
Parent organization
MAINEHEALTHAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Robert Hunter
Title
Senior Vice President
Phone
(207) 662-2272

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Corporate family (same tax ID) 14

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Facilities with the same owner 29

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 29

Practitioners 1

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

Medicare participation

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

Rural health clinic certification: CCN 208511

Medicare enrollment files
Legal name
MAINEHEALTH
Doing business as
MAINEHEALTH WALDOBORO HEALTH CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 1, 2004
Last certification
Jan 8, 2025
Ownership / control type
2B
Most recent change of ownership
Jan 1, 2019 (2 total)
Organization structure
CorporationNon-profit
Incorporated
Mar 21, 1951 in ME
Enrollment address
126 Depot St
Waldoboro, ME 04572-5913
Related CCNs
201302

All disclosed owners & managing parties 35

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Nancy a Hasenfus Individual Corporate DirectorBoard Member Jan 1, 2019
Melissa Smith Individual Corporate DirectorBoard Member Jan 1, 2019
Brett Loffredo Individual Corporate DirectorBoard Member Jan 1, 2019
Lugene a Inzana Individual Corporate OfficerAssociate Cfo Oct 17, 2023
Brian H Noyes Individual Corporate DirectorBoard Member Jan 1, 2019
Wayne R Printy Individual Corporate OfficerCfo Jul 1, 2003
Dawn M Tutt Individual W-2 Managing EmployeeRCM Systems Support Jan 1, 2019
Marie J McCarthy Individual Corporate DirectorBoard Member Jan 1, 2019
Matthew Chin Individual Corporate DirectorBoard Member Jan 1, 2025
Katherine B Coster Individual Corporate DirectorBoard Member Jan 1, 2019
Beth Kelsch Individual Corporate OfficerSecretary Oct 17, 2023
Robert Hunter Individual Corporate OfficerSenior Vice President Dec 1, 2025
Ann W Bresnahan Individual Corporate DirectorBoard Member Oct 1, 2023
Andrew T Mueller Individual Corporate OfficerCeo Apr 17, 2021
Lisa T Beaule Individual Corporate DirectorBoard Member Jan 1, 2019
Charles Richard Bayman Individual Corporate OfficerCfo Jan 1, 2025
Kelly a Elkins Individual Corporate OfficerCoo Oct 17, 2023
Peter W Wood Individual Corporate DirectorBoard Member Oct 17, 2023
Thomas J Ryan Individual Corporate DirectorBoard Member Jan 1, 2019
David J Kumaki Individual Corporate DirectorBoard Member Jan 1, 2019
Quincy Hentzel Individual Corporate DirectorBoard Member Jan 1, 2025
Morris L Fisher Individual Corporate DirectorBoard Member Jan 1, 2019
Leslie Clinton Boothby Individual Corporate DirectorBoard Member Jan 1, 2019
Kathleen Herlihy Individual Corporate DirectorBoard Member Jan 1, 2019
Katharine L Rose Individual W-2 Managing EmployeeLH Director of Reimbursement May 1, 2018
Mainehealth Services Organization, Portland, ME Non-profit 5% Or Greater Direct Ownership Interest Aug 26, 1996 100%
Linda M. Terry Individual Corporate DirectorBoard Member Oct 17, 2023
Heather R Shanklin Individual Corporate OfficerRegional Cfo Oct 1, 2025
Peter C Manning Individual Corporate DirectorBoard Member Jan 1, 2019
Alissa Chasse Individual W-2 Managing EmployeeRCM Systems Coordinator II Oct 17, 2023
Sandra Morrell-Rooney Individual Corporate DirectorBoard Member Oct 17, 2023
Daniel L Loiselle Individual Corporate DirectorBoard Member Jan 1, 2019
Matthew P Orlando Individual Corporate DirectorBoard Member Oct 1, 2024
Stuart H Watson Individual Corporate DirectorBoard Member Oct 17, 2023
Amanda Rand Individual Corporate DirectorBoard Member Oct 17, 2023

All facility ownership & control disclosures 2

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mid Coast Senior Health CenterBrunswick, ME, CCN 205163 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Jan 1, 2021
Oct 16, 2025
Coves EdgeDamariscotta, ME, CCN 205067 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Adp of the SNF		 Jan 1, 2019
Jan 1, 2019
Jan 1, 2019

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20181106000049 ME Part a Provider - Rural Health Clinic 7517860588 Practice locations: Waldoboro, ME

National Provider Directory

National Provider Directory
Tax ID family
Maine Medical Assoc (84 organizations share this tax ID)
Part of
Maine Medical Assoc

Specialties & licenses 7

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Rural Health Clinic/Center 261QR1300X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA289 ME
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X PA603 ME
Advanced Practice MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 367A00000X

Addresses

NPPES NPI Registry

Primary practice location

126 Depot St
Waldoboro, ME 04572-5913

Mailing address

PO Box 360489
Pittsburgh, PA 15251-6489
Phone (207) 563-4146

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1962573337-001MedicaidME

Other names 2

NPPES NPI Registry
  • MaineHealth Primary Care Family and Internal Medicine and Pediatrics Doing business as
  • MaineHealth Waldoboro Health Center Doing business as

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 31, 2026.

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774915200000",
    "number": "1962573337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360489",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152516489",
            "telephone_number": "207-563-4146",
            "fax_number": "207-563-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 DEPOT ST",
            "city": "WALDOBORO",
            "state": "ME",
            "postal_code": "045725913",
            "telephone_number": "207-832-6394",
            "fax_number": "207-832-4392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAINEHEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAINEHEALTH",
        "enumeration_date": "2006-11-10",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "207-662-2272"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA289",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "ME",
            "license": "PA603",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962573337-001",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MaineHealth Primary Care Family and Internal Medicine and Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MaineHealth Waldoboro Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waldoboro, ME

Sources for this page

Verify at the official NPI Registry.