NPIMap

Individual provider Active NPI

Megan Lynne Black, APRN, AGNP-C

  • Primary Care Nurse Practitioner
  • Portland, ME
National Provider Identifier
1982056347
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
CNP161083 Issued in ME
Practice address
43 Baxter Blvd
Portland, ME 04101-1823
Phone
(207) 771-1717
NPI assigned
Jul 11, 2016
Last updated
Jul 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X CNP161083 ME Primary

Addresses

Primary practice location

43 Baxter Blvd
Portland, ME 04101-1823

Mailing address

68 Pleasant St
Apt 2
Portland, ME 04101-3967
Phone (978) 257-3803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161012001574 ME Practitioner - Nurse Practitioner 8224326996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy HospitalGroup PAC ID 6103737812, 307 clinicians

Practice addresses (Care Compare)

43 Baxter Blvd
Portland, ME 04101-1894
Phone (207) 535-1150

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital CurrentSince Aug 7, 2016 Accepting new patients
Mercy Hospital CurrentSince Aug 7, 2016 Accepting new patients
Mercy Hospital Current Accepting new patients

Locations

43 Baxter Blvd
Portland, ME 04101
Phone (207) 771-1717

40 Park Rd
Westbrook, ME 04092
Phone (207) 857-8174

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 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1982056347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 PLEASANT ST",
            "address_2": "APT 2",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041013967",
            "telephone_number": "978-257-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 BAXTER BLVD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011823",
            "telephone_number": "207-771-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MEGAN",
        "middle_name": "LYNNE",
        "credential": "APRN, AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "ME",
            "license": "CNP161083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.