Individual provider Active NPI

Nicole Anne Wooley Carter, AGAC NP-BC

  • Nurse Practitioner
  • Bangor, ME
National Provider Identifier
1972352201
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP241212 Issued in ME
Practice address
Webber Medical Building
East, 417 State St Suite 121
Bangor, ME 04401
Phone
(207) 973-4266
NPI assigned
May 17, 2024
Last updated
Jun 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X CNP241212 ME
Nurse Practitioner 363L00000X CNP241212 ME Primary
Adult Health Nurse Practitioner 363LA2200X CNP241212 ME
Acute Care Nurse Practitioner 363LA2100X CNP241212 ME

Addresses

Primary practice location

Webber Medical Building
East, 417 State St Suite 121
Bangor, ME 04401

Mailing address

43 Whiting Hill Rd
Brewer, ME 04412-1005
Phone (207) 973-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240625003528 ME Practitioner - Nurse Practitioner 3577007061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

302 Husson Ave
Bangor, ME 04401-3374
Phone (207) 947-6141

417 State St
Bangor, ME 04401-6630

489 State St
Bangor, ME 04401-6616
Phone (207) 973-7000

55 Broadway
Suite 2
Bangor, ME 04401-5201
Phone (207) 947-0469

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP241212MEMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Maine Medical Center CurrentSince Jun 2, 2024 Accepting new patients
Eastern Maine Medical Center CurrentSince Jun 2, 2024 Accepting new patients
Mercy Hospital Past Accepting new patients

Locations

417 State St
Ste 121
Bangor, ME 04401
Phone (207) 947-0147

489 State St
Bangor, ME 04401
Phone (207) 973-8837

43 Whiting Hill Rd
Brewer, ME 04412
Phone (207) 973-5000

43 Whiting Hill Rd
Ste 250
Brewer, ME 04412

Organizations & group practices 3

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1972352201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121005",
            "telephone_number": "207-973-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WEBBER MEDICAL BUILDING",
            "address_2": "EAST, 417 STATE ST SUITE 121",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-973-4266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "NICOLE",
        "middle_name": "ANNE WOOLEY",
        "credential": "AGAC NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "ME",
            "license": "CNP241212",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP241212",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ME",
            "license": "CNP241212",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "ME",
            "license": "CNP241212",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.