Individual provider Active NPI

Clement B Lemieux, BA, PTA

  • Physical Therapy Assistant
  • Lewiston, ME
National Provider Identifier
1972320752
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PA1253 Issued in ME
Practice address
710 Main St
Lewiston, ME 04240-5801
Phone
(207) 599-1905
NPI assigned
Sep 24, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PA1253 ME Primary

Addresses

Primary practice location

710 Main St
Lewiston, ME 04240-5801

Mailing address

710 Main St
Lewiston, ME 04240-5801
Phone (207) 599-1905

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
PA1253MEMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1972320752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405801",
            "telephone_number": "207-599-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042405801",
            "telephone_number": "207-599-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMIEUX",
        "first_name": "CLEMENT",
        "middle_name": "B",
        "credential": "BA, PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ME",
            "license": "PA1253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.