Kelly McCoubrey, FNP
Individual provider Active NPI Family Nurse Practitioner · Meddybemps, ME
NPI 1982154951 · NPPES record last updated Sep 20, 2022
Key facts
- NPI
- 1982154951
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- CNP161166 (ME)
- Practice address
- 115 Conant Hill Rd
Meddybemps, ME 04657-4027 - Phone
- (207) 214-9355
- NPI assigned
- Oct 13, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Recover Together Inc
Practice addresses (Care Compare)
171 Capitol St
Suite 2
Augusta, ME 04330-6284
Phone (800) 683-8313
208 College Ave
Waterville, ME 04901-6225
Phone (800) 683-8313
265 Main St
Suite 201
Biddeford, ME 04005-3091
Phone (800) 683-8313
77 Park St
Rockland, ME 04841-2846
Phone (800) 683-8313
849 Stillwater Ave
Bangor, ME 04401-3624
Phone (800) 683-8313
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ME, NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190125001281 | ME | Practitioner - Nurse Practitioner | 2163609108 | Reassigns benefits to 2 organizations |
| I20210603001467 | NH | Practitioner - Nurse Practitioner | 2163609108 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP161166 | ME | MD | Family Nurse Practitioner |
| 084388-23 | NH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Recover Together, LLC | Family | Current |
Accepting new patients |
| Acadia Hospital Corp | Current |
Accepting new patients | |
| Acadia Healthcare, Inc | Past | Accepting new patients | |
| Down East Community Hospital | Past | Accepting new patients |
Locations
Dept CH17590
Palatine, IL 60055
Dept CH 17590
Palatine, IL 60055
Phone (844) 450-3100
111 S Bedford St
Ste 205
Burlington, MA 01803
Phone (512) 439-3547
268 Stillwater Ave
Bangor, ME 04401
Phone (207) 973-6470
77 Park St
Rockland, ME 04841
Phone (207) 245-7654
40 Winter St
Ste 204
Rochester, NH 03867
Phone (603) 556-8892
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 084388-23 | NH | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | CNP161166 | ME | |
| Family Nurse Practitioner | 363LF0000X | CNP161166 | ME | Yes |
Addresses
Primary practice location
115 Conant Hill Rd
Meddybemps, ME 04657-4027
Mailing address
115 Conant Hill Rd
Meddybemps, ME 04657-4027
Phone (207) 214-9355
Other providers in Meddybemps, ME
All providers in Meddybemps, ME · Family Nurse Practitioner in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.