KENNEBEC VALLEY RADIOLOGY PROFESSIONAL ASSOCIATION (NPI# 1730158734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730158734 |
| Entity Type | Organization |
| Organization Name | KENNEBEC VALLEY RADIOLOGY PROFESSIONAL ASSOCIATION |
| Practice Address |
28 Arsenal St Augusta ME 04330-5226 |
| Practice Telephone | 2076224231 |
| Practice Fax Number | 2076231580 |
| Mailing Telephone | 2076224231 |
| Mailing Fax Number | 2076231580 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2008-07-07 |
| Authorized Official Name | MRS. PAMELA S MANSIR (BUSINESS MANAGER) |
| Authorized Official Telephone | 2076224231 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | FEDERAL BC/BS | 0607 | 01 |
| ME | 106860000 | 05 | |
| ME | BC/BS OF MASS | 101613 | 01 |
| ME | AETNA | 0062588 | 01 |
| ME | ANTHEM BC/BS OF MAINE | 0607 | 01 |
| Street Address |
28 ARSENAL ST |
| City | AUGUSTA |
| State | ME |
| Zip Code | 04330-5226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649269440 | Seth M Hardy | Radiology | 28 Arsenal St, Augusta, ME 04330-5226 | 2005-10-14 |
| 1407828841 | Joseph T Laverdiere | Radiology | 28 Arsenal St, Augusta, ME 04330-5226 | 2006-02-01 |
| 1558348144 | Neil A Newton | Radiology | 28 Arsenal St, Augusta, ME 04330-5226 | 2005-12-27 |
| 1114904992 | Joseph R Metz | Radiology | 28 Arsenal St, Augusta, ME 04330-5226 | 2005-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770181877 | Renewal Family Center, LLC | Community/Behavioral Health | 10 Learners Drive, Augusta, ME 04330 | 2020-10-12 |
| 1134748759 | Chelsea Simone Koch | Registered Nurse | 1 Va Center, Department of Veterans Affairs, Augusta, ME 04330 | 2020-04-14 |
| 1790238442 | Nicole Lacrosse | Behavioral Analyst | 53 Hayden Rd, Augusta, ME 04330 | 2016-07-29 |
| 1093176844 | Richard J. Larrabee | Counselor | 312 Townhouse Road, Chelsea, ME 04330 | 2016-03-08 |
| 1376910984 | Sarah C. A. Tatlock | Social Worker | 41 Anthony Ave, Augusta, ME 04330 | 2015-08-31 |
| 1457728180 | Va Maine Health | General Acute Care Hospital | 1 Va Center 05, Va Maine Healthcare System-togus, Augusta, ME 04330 | 2015-08-28 |
| 1043696842 | Megan Arsenault | Pharmacist | 403 Water Street, Augusta, ME 04330 | 2015-08-04 |
| 1205219987 | Trevor Holbert | Audiologist | 1 Va Center - Togus Va Medical Center, Audiology 126a, Augusta, ME 04330 | 2015-06-30 |
| 1659787836 | Hannah M. Pullen | Occupational Therapy Assistant | 12 Shuman Ave Ste 16, Augusta, ME 04330 | 2014-07-08 |
| 1831469899 | Tanya Bernadette Quarterman | Specialist | 153 Hospital St Ste 13, Augusta, ME 04330 | 2012-01-09 |
| Find all providers in zip 04330 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841391570 | Sathy Gupta | Radiology | 1 Freedom Way (237), Augusta, GA 30904-6285 | 2006-09-26 |
| 1134172547 | Karl E Weingarten | Radiology | 630 13th Street, Suite 250, Augusta, GA 30901 | 2006-05-18 |
| 1649269440 | Seth M Hardy | Radiology | 28 Arsenal St, Augusta, ME 04330-5226 | 2005-10-14 |
| 1053317164 | Peter J Mascetta | Radiology | 6 East Chestnut Street, Augusta, ME 04333-0001 | 2005-06-23 |
| 1619474848 | Freyli Josefina Bustamante | Radiology | 1120 15th St, Augusta, GA 30912-0004 | 2018-04-13 |
| 1063861045 | Corey Garvin | Radiology | 1120 15th St, Augusta, GA 30912-0004 | 2016-06-09 |
| 1801244587 | Brian Sifrig | Radiology | 1120 15th St, Augusta, GA 30912-0004 | 2016-06-02 |
| 1851796270 | Ana R Fernandes Longuino | Radiology | 1120 15th St, Augusta, GA 30912-0001 | 2014-10-28 |
| 1093132979 | Hanping Wu | Radiology | 1120 15th St, Augusta, GA 30912-7101 | 2014-03-28 |
| 1235567843 | Maine Mobile Mri Associates | Radiology | 35 Medical Center Pkwy, Augusta, ME 04330-8160 | 2013-10-16 |
| Find all providers in AUGUSTA | ||||
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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.