SHIELDS PET/CT AT CMMC, LLC (NPI# 1245727296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245727296 |
| Entity Type | Organization |
| Organization Name | SHIELDS PET/CT AT CMMC, LLC |
| Practice Address |
105 Topsham Fair Mall Rd Topsham ME 04086-1773 |
| Mailing Address |
55 Christy Dr Brockton MA 02301-1813 |
| Practice Telephone | 8662584738 |
| Mailing Telephone | 5088971501 |
| Mailing Fax Number | 5088971599 |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2018-04-16 |
| Authorized Official Name | JEFFREY RONNER (CFO) |
| Authorized Official Telephone | 6073767400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0208X |
Clinic/Center Specialization: Radiology, Mobile |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982153052 | Shields Pet/ct At Cmmc, LLC | Clinic/Center | 300 Main St, Lewiston, ME 04240-7027 | 2016-09-29 |
| Street Address |
105 TOPSHAM FAIR MALL RD |
| City | TOPSHAM |
| State | ME |
| Zip Code | 04086-1773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063485035 | Danielle F. Bowen | Nurse Practitioner | 105 Topsham Fair Mall Rd, Topsham, ME 04086-1773 | 2006-02-09 |
| 1881246114 | Saco Bay Orthopaedic and Sports Physical Therapy, Inc. | Clinic/Center | 105 Topsham Fair Mall Rd, Topsham, ME 04086-1773 | 2019-07-16 |
| 1538621677 | Saco Bay Orthopaedic and Sports Physical Therapy, Inc. | Clinic/Center | 105 Topsham Fair Mall Rd, Topsham, ME 04086-1773 | 2019-04-05 |
| 1942797980 | Shields Imaging With Central Maine Health LLC | Clinic/Center | 105 Topsham Fair Mall Rd, Topsham, ME 04086-1773 | 2018-04-16 |
| 1396779757 | Teresa Weeks Sirois | Emergency Medicine | 105 Topsham Fair Mall Rd, Topsham, ME 04086-1773 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770196040 | Martha Densmore | Registered Nurse | 49 Topsham Fair Mall Rd., Topsham, ME 04086 | 2020-08-26 |
| 1972156727 | Wanho Lew | Dentist | 127 Topsham Fail Mall Rd., Topsham, ME 04086 | 2019-07-22 |
| 1326510595 | Apex Residential Support Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 196 Meadow Cross Rd, Topsham, ME 04086 | 2018-12-27 |
| 1891143681 | Kai N Cheng | Physician Assistant | 105 Topsham Fair Mall Rd Ste 8, Topsham, ME 04086 | 2016-06-02 |
| 1487028775 | Reform Physical Therapy, Inc | Physical Therapist | 439 Lewiston Rd, Topsham, ME 04086 | 2015-11-24 |
| 1457773301 | Kelly Fritz | Physical Therapist | 126 Main St Ste 3, Topsham, ME 04086 | 2014-01-13 |
| 1831493964 | Diane Lamere-wallace | Occupational Therapist | 19 Perkins Avenue, Topsham, ME 04086 | 2011-01-04 |
| 1376702597 | Julia Sullivan Cabral | Social Worker | 63 Elm Street, Ste B, Topsham, ME 04086 | 2008-06-03 |
| 1285830554 | Brian Roger Haney | Internal Medicine | 105 Topsham Fair Mall Rd Unit 1, Topsham, ME 04086 | 2007-06-25 |
| 1003917501 | Nancy A Porr | Nurse Practitioner | 4 Horton Place, Suite 101, Topsham, ME 04086 | 2006-09-26 |
| Find all providers in zip 04086 | ||||
| Taxonomy Code | 261QR0208X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mobile |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598380925 | Pdi Health Me LLC | Clinic/Center | 45 Portland Rd, Kennebunk, ME 04043-6660 | 2020-06-11 |
| 1740563428 | Insight-premier Health LLC | Clinic/Center | 27 Bowdoin Street, Manchester, ME 04351 | 2011-09-20 |
| 1720166697 | New England Mobile X-ray | Clinic/Center | 891 Brighton Ave, Suite 3, Portland, ME 04102-1056 | 2006-11-01 |
| 1427061969 | Introspective Imaging Inc. | Clinic/Center | 29 Crossing Brook Rd, Cumberland, ME 04021-4123 | 2006-08-14 |
| 1750828539 | Shields Imaging At York Hospital LLC | Clinic/Center | 114 Sanford Rd, Wells, ME 04090-5533 | 2017-01-31 |
| 1982153052 | Shields Pet/ct At Cmmc, LLC | Clinic/Center | 300 Main St, Lewiston, ME 04240-7027 | 2016-09-29 |
| 1902100555 | Insight Premier Health | Clinic/Center | 51 Us Route 1, Suite O, Scarborough, ME 04074-7158 | 2010-12-22 |
| 1982649158 | New England Molecular Imaging LLC | Clinic/Center | 300 Main St, Lewiston, ME 04240-7007 | 2006-06-19 |
| 1730122508 | New England Molecular Imaging LLC | Clinic/Center | 15 Hospital Dr, York, ME 03909-1011 | 2006-06-13 |
Please comment or provide details below to improve the information on SHIELDS PET/CT AT CMMC, LLC.
| 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.