JOHN A DUDLEY (NPI# 1710238126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710238126 |
| Entity Type | Individual |
| Full Name | JOHN A DUDLEY |
| Credential | PA-C |
| Practice Address |
1250 Forest Ave Suite 301 Portland ME 04103-1889 |
| Mailing Address |
301c Us Route 1 Scarborough ME 04074-9701 |
| Practice Telephone | 2077975753 |
| Practice Fax Number | 2077979571 |
| Mailing Telephone | 2073968600 |
| Mailing Fax Number | 2073968632 |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2014-02-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5164 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 5164 | AZ | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 749101 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508990151 | John W Dudley | Hearing Instrument Specialist | 6040 S Padre Island Dr, Corpus Christi, TX 78412-3922 | 2007-03-15 |
| 1881608396 | John H Dudley | Chiropractor | 1595 Lakeside Dr, Reno, NV 89509 | 2006-07-28 |
| 1518461672 | John Dudley | Behavior Technician | 1109 Jones St, Kennett, MO 63857-3824 | 2018-03-22 |
| 1679923254 | John Dudley | Internal Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2016-06-15 |
| 1083025944 | John Michael Dudley | Dietitian, Registered | 6856 Cobblestone Blvd, Southaven, MS 38672-9311 | 2014-05-14 |
| 1598829152 | John B Dudley | Physical Therapist | 1381 Jefferson Rd, Northfield, MN 55057-3080 | 2006-12-20 |
| 1316024045 | John Paul Dudley | Chiropractor | 301 S Broad St, Mooresville, NC 28115-3207 | 2006-11-01 |
| 1033203914 | John A Dudley | Dentist | 172 Mt Pleasant Rd, Newtown, CT 06470 | 2006-10-03 |
| Street Address |
1250 FOREST AVE SUITE 301 |
| City | PORTLAND |
| State | ME |
| Zip Code | 04103-1889 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447254057 | Robert R. Denton | Physical Therapist | 1250 Forest Ave, Portland, ME 04103-1884 | 2005-06-10 |
| 1740724228 | Lindsey Jean Koocher | Nurse Practitioner | 1250 Forest Ave, Portland, ME 04103-1889 | 2016-12-19 |
| 1568828846 | Athena Beaulieu | Physical Therapist | 1250 Forest Ave, Portland, ME 04103-1889 | 2016-01-03 |
| 1962803940 | Robert Taylor Dpm PC | Podiatrist | 1250 Forest Ave, Suite 303, Portland, ME 04103-1889 | 2014-09-10 |
| 1215360110 | Kevin Michael Lukis | Dentist | 1250 Forest Ave, Ste 3b, Portland, ME 04103-1889 | 2013-08-14 |
| 1588000954 | Rebecca Harvey | Otolaryngology | 1250 Forest Ave, Portland, ME 04103 | 2013-05-13 |
| 1700134525 | Matthew M. Papsadora | Physical Therapist | 1250 Forest Ave, Portland, ME 04103-1889 | 2012-08-28 |
| 1295081172 | Lindsay Ann Ekey | Audiologist | 1250 Forest Ave, Suite 301, Portland, ME 04103-1889 | 2012-07-30 |
| 1821396094 | Stacia L. Thomas | Audiologist | 1250 Forest Ave, Ste 301, Portland, ME 04103-1889 | 2011-03-11 |
| 1649577768 | Mainehealth | Audiologist | 1250 Forest Ave, Portland, ME 04103 | 2011-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1982251435 | Hope Home Healthcare, LLC | Home Health | 68 Bishop St Unit 3 #2, Portland, ME 04103 | 2019-08-20 |
| 1992367023 | Care for Everyone | In Home Supportive Care | 68 Bishop Street, Unit 1, Room 5, Portland, ME 04103 | 2019-06-28 |
| 1093373458 | Emanuel Nistrian | Student in an Organized Health Care Education/Training Program | Une, 716 Stevens Ave., Portland, ME 04103 | 2019-05-31 |
| 1023676483 | Robert Montague | Student in an Organized Health Care Education/Training Program | University of New England, 716 Stevens Ave, Portland, ME 04103 | 2019-05-31 |
| 1154838027 | Kimberly Therriault | Behavior Technician | 527 Ocean Ave Ste 19, Portland, ME 04103 | 2018-01-02 |
| 1285147918 | Teresa Maalouf | Community Health Worker | 23 Cambridge St., Portland, ME 04103 | 2017-11-16 |
| 1578082244 | Darcelle Kay Stillman | Occupational Therapist | 90 Dorothy St, Portland, ME 04103 | 2017-09-14 |
| 1821524943 | Engility Enterprises LLC | Case Management | 1 Coast Lane, Portland, ME 04103 | 2017-05-10 |
| 1720524283 | Hannah Rose Kazilionis | Counselor | 257 Deering Ave # 204, Portland, ME 04103 | 2017-01-09 |
| Find all providers in zip 04103 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427676493 | Lindsey Louise Peterson | Physician Assistant | 3505 N Williams Ave, Portland, OR 97227-1437 | 2020-07-07 |
| 1518584036 | Abigail Nichole Dumont | Physician Assistant | 6064 Sw 30th Ave, Portland, OR 97239-1018 | 2020-06-30 |
| 1336769637 | Molly Tanguay | Physician Assistant | 23 Bramhall St, Portland, ME 04102-3121 | 2020-04-16 |
| 1063040525 | Jessica Nursick | Physician Assistant | 26 Sand Hill Rd, Portland, CT 06480-1737 | 2020-03-31 |
| 1689217630 | Evan Eisher | Physician Assistant | 3809 Se Stephens St, Portland, OR 97214-5248 | 2019-10-22 |
| 1508407941 | Amie Bates | Physician Assistant | 1040 Nw 22nd Ave # Ll030, Portland, OR 97210-3057 | 2019-10-07 |
| 1558923326 | Mackenzie Graye Mcmillin | Physician Assistant | 1601 Congress St Ste 1, Portland, ME 04102-2145 | 2019-07-02 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1942794839 | Michael Peterson | Physician Assistant | 3181 Sw Sam Jackson Park Rd # P31, Portland, OR 97239-3098 | 2018-06-14 |
| 1306383930 | Rachel Lynn Witowski | Physician Assistant | 2124 Nw Hoyt St, Portland, OR 97210-3215 | 2017-01-20 |
| Find all providers in PORTLAND | ||||
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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.