STATE OF MAINE (NPI# 1053319566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053319566 |
| Entity Type | Organization |
| Organization Name | STATE OF MAINE |
| Other Organization Name | RIVERVIEW PSYCHIATRIC HOSPITAL |
| Practice Address |
250 Arsenal St Augusta ME 04333-0011 |
| Mailing Address |
109 Capitol Street Shs #11 Reimbursement Unit Augusta ME 04333-0011 |
| Practice Telephone | 2072872293 |
| Practice Fax Number | 2072871862 |
| Mailing Telephone | 2072872293 |
| Mailing Fax Number | 2072871862 |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2019-06-14 |
| Authorized Official Name | MS. JENNIFER GAGNON (FINANCIAL MANAGER) |
| Authorized Official Telephone | 2076244675 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 135910901 | 05 | |
| ME | MEDICARE ID | 204008 | 01 |
| ME | BLUE CROSS | 003287 | 01 |
| Other Name | Type Code |
|---|---|
| Riverview Psychiatric Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356678387 | State of Maine | Public Health or Welfare | 286 Water Street, 9th Floor, Augusta, ME 04333-0011 | 2009-11-12 |
| 1649413360 | State of Maine | Case Management | 32 Blossom Ln, Augusta, ME 04333-0001 | 2009-04-10 |
| 1871708230 | State of Maine | Local Education Agency (LEA) | 23 State House Sta, Augusta, ME 04333-0023 | 2007-05-11 |
| 1699776146 | State of Maine | Psychiatric Hospital | 656 State St, Bangor, ME 04401-5609 | 2005-08-09 |
| 1184020091 | State of Maine | Community/Behavioral Health | 656 State St, Bangor, ME 04401-5609 | 2014-11-05 |
| 1225374549 | State of Maine | Clinic/Center | 32 Blossom Ln, Augusta, ME 04333-0011 | 2012-12-13 |
| 1063741213 | State of Maine | Case Management | 32 Blossom Ln, Augusta, ME 04333-0011 | 2009-12-17 |
| 1386887008 | State of Maine | Community/Behavioral Health | 5 Caldwell Rd, Augusta, ME 04330-0011 | 2009-04-10 |
| 1376781153 | State of Maine | Point of Service | 91 Camden St, Suite 103, Rockland, ME 04841-2455 | 2009-02-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | STATE OF MAINE ENTERPRISE LLC | 2515 Coral Ct., N. Bellmore, Ny 11710 |
| System for Award Management (SAM) Entities | STATE OF MAINE, CONNECTME AUTHORITY | 211 Sewall St, Augusta, ME 04333-0001 |
| Street Address |
250 ARSENAL ST |
| City | AUGUSTA |
| State | ME |
| Zip Code | 04333-0011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427686484 | Karen Sherlock | Registered Nurse | 250 Arsenal St, Augusta, ME 04330-3599 | 2020-03-27 |
| 1316592892 | Demetra Keith | Nurse Practitioner | 250 Arsenal St, Augusta, ME 04330-5742 | 2019-08-01 |
| 1730732967 | Jorie W Ohlson | Nurse Practitioner | 250 Arsenal St, Augusta, ME 04330-3599 | 2019-07-17 |
| 1144766734 | Jason Grundstrom-whitney | Counselor | 250 Arsenal St, Augusta, ME 04330-5742 | 2017-01-06 |
| 1053781492 | Kelly Lemieux Dudley | Nurse Practitioner | 250 Arsenal St, Augusta, ME 04330-5742 | 2015-09-28 |
| 1801263520 | Sarah Perry | Pharmacist | 250 Arsenal St, Augusta, ME 04330-5742 | 2015-08-28 |
| 1285027318 | Lorraine Zamudio | Psychologist | 250 Arsenal St, Augusta, ME 04330-5742 | 2015-03-13 |
| 1962819201 | Susan Fasulo | Social Worker | 250 Arsenal St, State House Station 11, Augusta, ME 04330-5742 | 2014-07-18 |
| 1003042185 | Regana Contini Sisson | Psychiatry & Neurology | 250 Arsenal St, Augusta, ME 04333-0011 | 2009-06-03 |
| 1295986982 | Ingrid Prikryl | Dentist | 250 Arsenal St, Augusta, ME 04330-5742 | 2008-10-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962757476 | Stacia K St. John | Registered Nurse | 1 Togus Ctr, Augusta, ME 04333-0001 | 2012-07-20 |
| 1649413360 | State of Maine | Case Management | 32 Blossom Ln, Augusta, ME 04333-0001 | 2009-04-10 |
| 1487864930 | Shaun Quimby | Social Worker | 1 Weston Ct Fl 3, Augusta, ME 04333-0001 | 2007-05-23 |
| 1689793077 | Elsie J Freeman | Psychiatry & Neurology | Main Dhhs, 11 State House Station, Augusta, ME 04333-0001 | 2007-03-28 |
| 1407985302 | State of Maine Health and Environmental Tessting Laboratory | Clinical Medical Laboratory | Station 12, 221 State Street, Augusta, ME 04333-0001 | 2007-03-05 |
| 1053317164 | Peter J Mascetta | Radiology | 6 East Chestnut Street, Augusta, ME 04333-0001 | 2005-06-23 |
| 1326081076 | Grace Odimayo | Dentist | 250 Arsenal Street, 11 Shs, Augusta, ME 04333-0001 | 2006-06-13 |
| 1538144860 | George Edward Davis | Internal Medicine | 250 Arsenal Street, 11 Shs, Augusta, ME 04333-0001 | 2005-12-09 |
| 1427370014 | Susan Waldron Newkirk-sanborn | Psychologist | 250 Arsenal St., 11 State House Station, Augusta, ME 04333-0011 | 2010-02-23 |
| 1356678387 | State of Maine | Public Health or Welfare | 286 Water Street, 9th Floor, Augusta, ME 04333-0011 | 2009-11-12 |
| Find all providers in zip 04333 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093046005 | Department of Behavioral Health and Developmental Disabilities | Psychiatric Hospital | 3405 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2010-01-15 |
| 1306940879 | Va Medical Center | Psychiatric Hospital | 1 Freedom Way, Augusta, GA 30904-6258 | 2006-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699776146 | State of Maine | Psychiatric Hospital | 656 State St, Bangor, ME 04401-5609 | 2005-08-09 |
| 1790265502 | Mainehealth | Psychiatric Hospital | 123 Andover Rd, Westbrook, ME 04092-3848 | 2018-08-21 |
| 1578911830 | Acadia Hospital | Psychiatric Hospital | 268 Stillwater Ave, Bangor, ME 04401-3945 | 2016-05-27 |
| 1215940523 | Acadia Hospital Corp | Psychiatric Hospital | 268 Stillwater Avenue, Bangor, ME 04401 | 2006-08-15 |
| 1598798787 | Mainehealth | Psychiatric Hospital | 123 Andover Rd, Westbrook, ME 04092-3848 | 2006-07-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.