Individual provider Active NPI

Samantha Doe, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Brunswick, ME
National Provider Identifier
1982093753
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP141119 Issued in ME
Practice address
51 Harpswell Rd
Brunswick, ME 04011-2549
Phone
(207) 295-2190
NPI assigned
Jan 16, 2015
Last updated
Aug 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP141119 ME
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP141119 ME Primary

Addresses

Primary practice location

51 Harpswell Rd
Brunswick, ME 04011-2549

Mailing address

50 Crestmont Ave
Millinocket, ME 04462-1906
Phone (207) 504-0588

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
I20150320001828 ME Practitioner - Nurse Practitioner 8527385012 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNP141119MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maine Medical Partners Current Accepting new patients
Maine Medical Partners CurrentSince Jun 14, 2021 Accepting new patients
Maine Medical Partners CurrentSince Jun 14, 2021 Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

100 Campus Dr
Unit 107
Scarborough, ME 04074
Phone (207) 396-7565

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.

NPI Registry JSON

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1982093753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CRESTMONT AVE",
            "city": "MILLINOCKET",
            "state": "ME",
            "postal_code": "044621906",
            "telephone_number": "207-504-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 HARPSWELL RD",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112549",
            "telephone_number": "207-295-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOE",
        "first_name": "SAMANTHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-16",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP141119",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ME",
            "license": "CNP141119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

Verify at the official NPI Registry.