Individual provider Active NPI

Jessica Lynn Hart McCannell

  • Physical Therapist
  • Bangor, ME
National Provider Identifier
1972395515
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7147 Issued in ME
Practice address
82 Sylvan Rd
Bangor, ME 04401-4221
Phone
(207) 401-4324
Fax
(207) 401-4325
NPI assigned
May 20, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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 PT7147 ME Primary

Addresses

Primary practice location

82 Sylvan Rd
Bangor, ME 04401-4221

Mailing address

82 Sylvan Rd
Bangor, ME 04401-4221
Phone (207) 401-4324

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250602001682 ME Practitioner - Physical Therapist in Private Practice 0446769442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County Physical Therapy LLCGroup PAC ID 3779520242, 19 clinicians

Practice addresses (Care Compare)

82 Sylvan Rd
Bangor, ME 04401-4221
Phone (207) 401-4324

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County Physical Therapy, LLC Physical Therapist CurrentSince May 27, 2025 Accepting new patients

Locations

82 Sylvan Rd
Bangor, ME 04401
Phone (207) 401-4324

118 Bennett Dr
Ste 140
Caribou, ME 04736
Phone (207) 498-6334

Organizations & group practices 1

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": "1747699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1972395515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 SYLVAN RD",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014221",
            "telephone_number": "207-401-4324",
            "fax_number": "207-401-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 SYLVAN RD",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014221",
            "telephone_number": "207-401-4324",
            "fax_number": "207-401-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCANNELL",
        "first_name": "JESSICA",
        "middle_name": "LYNN HART",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-05-20",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT7147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; 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.