PENOBSCOT COMMUNITY HEALTH CENTER (NPI# 1629161559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629161559 |
| Entity Type | Organization |
| Organization Name | PENOBSCOT COMMUNITY HEALTH CENTER |
| Other Organization Name | HELEN HUNT HEALTH CENTER |
| Practice Address |
242 Brunswick St Old Town ME 04468 |
| Mailing Address |
Po Box 1599 Bangor ME 04402-1599 |
| Practice Telephone | 2078276128 |
| Practice Fax Number | 2078275533 |
| Mailing Telephone | 2079455247 |
| Mailing Fax Number | 2079922154 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2018-08-06 |
| Authorized Official Name | LORI L. DWYER (PRESIDENT & CEO) |
| Authorized Official Telephone | 2079929200 |
| Authorized Official Credential | ESQ. |
| Is Organization Subpart | Y |
| Parent Organization Name | PENOBSCOT COMMUNITY HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
201847 FQHC MEDI | ME | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 131160200 | 05 |
| Other Name | Type Code |
|---|---|
| Helen Hunt Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760973960 | Penobscot Community Health Center | Clinic/Center | 1012 Union St Ste 3, Bangor, ME 04401-3058 | 2018-05-23 |
| 1134632870 | Penobscot Community Health Center | Community/Behavioral Health | 85 Hammond St, Bangor, ME 04401-4913 | 2017-11-15 |
| 1720535651 | Penobscot Community Health Center | Dentist | 100 Moosehead Blvd, Bangor, ME 04401 | 2016-09-08 |
| 1174845697 | Penobscot Community Health Center | Clinic/Center | 181 Corporate Drive, Bangor, ME 04401 | 2010-02-25 |
| 1013000942 | Penobscot Community Health Center | General Practice | 79 Parkway S, Brewer, ME 04412 | 2006-10-02 |
| 1831282771 | Penobscot Community Health Center | Family Medicine | 1048 Union St, Suite 5, Bangor, ME 04401-8600 | 2006-10-02 |
| 1922191857 | Penobscot Community Health Center | General Practice | 92 Pendleton St, Brewer, ME 04412 | 2006-10-02 |
| 1659464584 | Penobscot Community Health Center | Family Medicine | 992 Union St. Suite J, Bangor, ME 04402 | 2006-10-02 |
| 1083259410 | Penobscot Community Health Center | Family Medicine | 1068 Union St, Bangor, ME 04401-3016 | 2019-11-08 |
| 1366800138 | Penobscot Community Health Center | Clinic/Center | 376 Main St, Jackman, ME 04945-5214 | 2016-02-08 |
| Street Address |
242 BRUNSWICK ST |
| City | OLD TOWN |
| State | ME |
| Zip Code | 04468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841283959 | Kay M Nash | Physician Assistant | 242 Brunswick St, Old Town, ME 04468-1613 | 2005-08-24 |
| 1578194585 | Kara Middleton | Physician Assistant | 242 Brunswick St, Old Town, ME 04468-1613 | 2020-01-29 |
| 1497317457 | Olivia Jasmin Greer | Physician Assistant | 242 Brunswick St, Old Town, ME 04468-1613 | 2019-06-30 |
| 1215595749 | Justin J Cloukey | Nurse Practitioner | 242 Brunswick St, Old Town, ME 04468-1613 | 2019-05-30 |
| 1144791849 | Destiny R Reynolds | Nurse Practitioner | 242 Brunswick St, Old Town, ME 04468-1613 | 2018-12-07 |
| 1174020432 | Rachel Laura Kinney | Nurse Practitioner | 242 Brunswick St, Old Town, ME 04468-1613 | 2018-04-12 |
| 1992219455 | Jeffrey Walton | Physical Therapist | 242 Brunswick St, Old Town, ME 04468-1613 | 2017-11-20 |
| 1518497395 | Collin Francis Zelinsky | Physician Assistant | 242 Brunswick St, Old Town, ME 04468-1613 | 2017-06-14 |
| 1407307101 | James Cash Sr. | Chiropractor | 242 Brunswick St, Old Town, ME 04468-1613 | 2016-10-18 |
| 1760932552 | Amanda Langworthy | Registered Nurse | 242 Brunswick St, Old Town, ME 04468-1613 | 2016-10-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770730012 | Karen Laflamme Davis | Speech-Language Pathologist | 270-a Main St, Old Town, ME 04468 | 2008-08-19 |
| 1104028281 | Susan C Hoovler | Licensed Practical Nurse | 242 Brunswick St., Penobscot Community Health Center, Old Town, ME 04468 | 2007-06-01 |
| 1326251000 | City of Old Town | Local Education Agency (LEA) | 156 Oak St., Old Town, ME 04468 | 2007-05-08 |
| 1891832382 | Nancy J. Mitchell Home Trust | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1 Sandy Beach Lane, Indian Island, ME 04468 | 2007-01-31 |
| 1639274913 | Dianne E Kallen | Family Medicine | 252 Brunswick St, Old Town, ME 04468 | 2006-09-13 |
| 1023510898 | Riversedge Chiropractic Wellness Center LLC | Clinic/Center | 227 Main St, Old Town, ME 04468 | 2018-03-07 |
| 1134350077 | Kaliope C. Parousis | Pediatrics | 242 Brunswick Street, Old Town, ME 04468 | 2009-07-27 |
| 1568673267 | Merla Roy | Technician, Pathology | 23 Wabanaki Way, Indian Island, ME 04468 | 2007-05-24 |
| 1154440113 | Mckay Shared Living Services | Custodial Care Facility | 240 Main Street, Old Town, ME 04468 | 2007-03-28 |
| 1225153851 | Margo Downing | Registered Nurse | 23 Wabanaki Way, Indian Island, ME 04468 | 2007-03-20 |
| Find all providers in zip 04468 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053625921 | Penobscot Community Health Center | Clinic/Center | 242 Brunswick St, Old Town, ME 04468-1613 | 2010-08-03 |
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|---|---|---|---|---|
| 1023621273 | Sebasticook Family Doctors | Clinic/Center | 291 Williams Road, Newport, ME 04953 | 2020-08-27 |
| 1295386316 | Community Clinical Services, Inc | Clinic/Center | 1250 Turner St, Auburn, ME 04210-6436 | 2019-09-20 |
| 1679047872 | Portland Community Health Center | Clinic/Center | 52 Frederic St, Portland, ME 04102-2700 | 2019-01-22 |
| 1043783822 | Portland Community Health Center | Clinic/Center | 72 Bishop St, Portland, ME 04102-2957 | 2019-01-04 |
| 1770056558 | Portland Community Health Center | Clinic/Center | 190 Valley Street, Portland, ME 04102-2957 | 2019-01-04 |
| 1760973960 | Penobscot Community Health Center | Clinic/Center | 1012 Union St Ste 3, Bangor, ME 04401-3058 | 2018-05-23 |
| 1700317971 | Portland Community Health Center | Clinic/Center | 28 Portland St, Portland, ME 04101-2912 | 2017-03-21 |
| 1184165367 | Katahdin Valley Health Center | Clinic/Center | 65 South St, Houlton, ME 04730-1550 | 2017-03-20 |
| 1255872537 | Portland Community Health Center | Clinic/Center | 175 Auburn St, Portland, ME 04103-2131 | 2017-03-20 |
| 1881135192 | Portland Community Health Center | Clinic/Center | 353 Cumberland Avenue, Cliff Island, ME 04109-0008 | 2017-03-20 |
| Find all providers with the same taxonomy | ||||
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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.