Gregory Thibodeau, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

EC131109 Issued in ME

Practice address

76 High St
Lewiston, ME 04240-7649

Phone

(207) 795-2800

NPI assigned

Jul 9, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Central Maine Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1689653487
  NPD (past)
• Central Maine Medical Center

  • Community/Retail Pharmacy
  • Lewiston, ME
  • NPI 1861433765
  NPD (past)

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1982045720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 HIGH ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407649",
            "telephone_number": "207-795-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 HIGH ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407649",
            "telephone_number": "207-795-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAU",
        "first_name": "GREGORY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-09",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "EC131109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn D Theriault, LSW
• Elaine C Therriault
• Autumn J Therrien, RDH
• Ethan Therrien, LCPC-C
• Bette Jane Thibeault, LMT
• Amy L Thiele, LCSW
• Jija Thomas, MD
• Michael A Thomas, LCPC
• Susan A. Thomas, MD
• Tison Thomas, D.O.

• Family Medicine Physician in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; 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.