Active NPI
Convenientmd LLC
- Urgent Care Clinic/Center
- Saco, ME
National Provider Identifier
1972151348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- Legal business name
- CONVENIENTMD LLC
- Practice address
- 506 Main St
Saco, ME 04072-1530 - Phone
- (207) 571-7991
- NPI assigned
- Aug 29, 2019
- Last updated
- Aug 29, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gareth Dickens
- Title
- Executive Chairman
- Phone
- (603) 501-0863
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | NU | Primary |
Addresses
Primary practice location
506 Main St
Saco, ME 04072-1530
Mailing address
111 NH Ave Ste 2
Portsmouth, NH 03801-2864
Phone (603) 410-6700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180220000535 | ME | Part B Supplier - Clinic/Group Practice | 2062667033 |
Receives reassigned benefits from 9 practitioners 12 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ellsworth, ME; Saco, ME; Sanford, ME; Westbrook, ME; Portland, ME; Bangor, ME; Augusta, ME; Auburn, ME… |
Other NPIs on the same Medicare enrollment 12
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567036800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1567036800000",
"number": "1972151348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 NH AVE STE 2",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038012864",
"telephone_number": "603-410-6700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 MAIN ST",
"city": "SACO",
"state": "ME",
"postal_code": "040721530",
"telephone_number": "207-571-7991"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONVENIENTMD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-08-29",
"last_updated": "2019-08-29",
"status": "A",
"authorized_official_last_name": "DICKENS",
"authorized_official_first_name": "GARETH",
"authorized_official_title_or_position": "EXECUTIVE CHAIRMAN",
"authorized_official_telephone_number": "603-501-0863"
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saco, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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.