Crown Pathology P a

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

012546 Issued in ME

Legal business name

CROWN PATHOLOGY P A

Practice address

140 Academy St
Presque Isle, ME 04769-3102

Phone

(207) 768-4209

Fax

(207) 768-4013

NPI assigned

Oct 30, 2014

Organization subpart

No

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

Authorized official

Name

John Tewksbury

Title

Owner

Phone

(207) 768-4013

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• John C Gershman-Tewksbury, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Presque Isle, ME
  • NPI 1053335992
  NPD (past)

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414627200000",
    "number": "1972908184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 STATE PARK RD",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047695247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 ACADEMY ST",
            "city": "PRESQUE ISLE",
            "state": "ME",
            "postal_code": "047693102",
            "telephone_number": "207-768-4209",
            "fax_number": "207-768-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN PATHOLOGY P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-30",
        "last_updated": "2014-10-30",
        "status": "A",
        "authorized_official_last_name": "TEWKSBURY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-768-4013"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "ME",
            "license": "012546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962423814",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Arthur Cowley, CRNA
• Alexis Rae Craig, MS, OT/L
• Shea Gabriella Craig, MS OTR/L
• Bredon Crawford, MD
• Crown Gastroenterology Associates
• Crown Pathology, PA
• Melanie A. Cullins, OQMHP-COMMUNITY
• Heather Jean Curran, FNP
• Angela L Curtis
• Cathy L Cyr, MHRT-CSP

• Clinical Pathology/Laboratory Medicine Physician in Presque Isle, ME
• Providers in Presque Isle, ME by specialty
• Clinical Pathology/Laboratory Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.