NPIMap

Organization Active NPI

Penobscot Community Health Care

  • Family Medicine Physician
  • Hampden, ME
National Provider Identifier
1992734164
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PENOBSCOT COMMUNITY HEALTH CARE
Practice address
177 Coldbrook Road
Hampden, ME 04444-0000
Phone
(207) 862-2227
Fax
(207) 862-2252
NPI assigned
Jul 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kevin J Kelley
Title
Chief Operating Officer
Phone
(207) 945-5247

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

177 Coldbrook Road
Hampden, ME 04444-0000

Mailing address

1048 Union St
Suite 5
Bangor, ME 04401-8600
Phone (207) 945-5247

National Provider Directory

National Provider Directory
Tax ID family
Penobscot Community Hea40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Locations

177 Coldbrook Rd
Hampden, ME 04444
Phone (207) 862-2088

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992734164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1048 UNION ST",
            "address_2": "SUITE 5",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044018600",
            "telephone_number": "207-945-5247",
            "fax_number": "207-992-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 COLDBROOK ROAD",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "044440000",
            "telephone_number": "207-862-2227",
            "fax_number": "207-862-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENOBSCOT COMMUNITY HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "207-945-5247"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampden, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.