Individual provider Active NPI

Christina Hammond Vietor, DO

  • Family Medicine Physician
  • South Portland, ME
National Provider Identifier
1982965794
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO2610 Issued in ME
Practice address
100 Foden Rd, East
Suite 203
South Portland, ME 04106-1316
Phone
(207) 874-1489
Fax
(207) 523-8590
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP60562552 WA
Family Medicine Physician 207Q00000X DO2610 ME Primary

Addresses

Primary practice location

100 Foden Rd, East
Suite 203
South Portland, ME 04106-1316

Mailing address

100 Gannett Dr
Suite C
South Portland, ME 04106-5900
Phone (207) 828-0361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OP60562552WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1982965794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GANNETT DR",
            "address_2": "SUITE C",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041065900",
            "telephone_number": "207-828-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FODEN RD, EAST",
            "address_2": "SUITE 203",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041061316",
            "telephone_number": "207-874-1489",
            "fax_number": "207-523-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIETOR",
        "first_name": "CHRISTINA",
        "middle_name": "HAMMOND",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60562552",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "DO2610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.