Individual provider Active NPI

Bethany Rose McInnis, APRN

  • Family Nurse Practitioner
  • Norway, ME
National Provider Identifier
1982213609
Registry record updated Aug 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP201234 Issued in ME
Practice address
181 Main St
Norway, ME 04268-5664
Phone
(207) 744-6117
NPI assigned
Jul 28, 2020
Last updated
Aug 26, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP201234 ME Primary

Addresses

Primary practice location

181 Main St
Norway, ME 04268-5664

Mailing address

265 Western Ave Ste 2
South Portland, ME 04106-2458
Phone (207) 661-0200

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Norway

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
I20200916000627 ME Practitioner - Nurse Practitioner 2163840695 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP201234MEMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Sep 8, 2020 Accepting new patients
Mainehealth CurrentSince Sep 8, 2020 Accepting new patients
Mainehealth Current Accepting new patients
Mainehealth Current Accepting new patients

Locations

181 Main St
Norway, ME 04268
Phone (207) 743-5933

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

265 Western Ave
Ste 2
South Portland, ME 04106
Phone (207) 661-0200

Interoperability endpoints

  • Direct secure messaging: bmcinnis5589@direct.mmc.mainehealth.org

Organizations & group practices 4

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": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1982213609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 WESTERN AVE STE 2",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062458",
            "telephone_number": "207-661-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 MAIN ST",
            "city": "NORWAY",
            "state": "ME",
            "postal_code": "042685664",
            "telephone_number": "207-744-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "BETHANY",
        "middle_name": "ROSE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP201234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Norway",
            "affiliation": "N",
            "address_1": "181 Main St",
            "city": "Norway",
            "state": "ME",
            "country_code": "US",
            "postal_code": "042685664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Norway, ME

Sources for this page

Verify at the official NPI Registry.