DR. GILBERT M WILCOX (NPI# 1750446936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750446936 |
| Entity Type | Individual |
| Full Name | DR. GILBERT M WILCOX |
| Credential | MD |
| Practice Address |
161 Marginal Way Portland ME 04101-2438 |
| Practice Telephone | 2077737964 |
| Practice Fax Number | 2077739073 |
| Mailing Telephone | 2077743461 |
| Mailing Fax Number | 2077743463 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2019-12-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 0102139 | ME | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | RAILROAD MEDICARE | 100003458 | 01 |
| ME | FEDERAL TAX ID | 01-0418797 | 01 |
| ME | 117070000 | 05 | |
| ME | ANTHEM STAR NUMBER | 037916 | 01 |
| ME | TRICARE | E001889 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 131 Chadwick St, Suite 2, Portland, ME 041023214 | 2077743461 | 2077743463 |
| Street Address |
161 MARGINAL WAY |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101-2438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518963677 | Jeffrey K Moore | Ophthalmology | 161 Marginal Way, Portland, ME 04101-2438 | 2005-06-23 |
| 1477952075 | Karen Stoughton | Nurse Practitioner | 161 Marginal Way, Portland, ME 04101-2438 | 2014-08-19 |
| 1376950337 | Ekaterina Funk | Nurse Practitioner | 161 Marginal Way, Portland, ME 04101-2438 | 2014-07-22 |
| 1831534031 | Cristina Churchill Rutherford | Internal Medicine | 161 Marginal Way, Portland, ME 04101-2438 | 2013-05-02 |
| 1376986513 | Kelly Daylyn Pizzo | Internal Medicine | 161 Marginal Way, Portland, ME 04101-2438 | 2013-04-08 |
| 1164710075 | Noemi Baffy | Internal Medicine | 161 Marginal Way, Portland, ME 04101-2438 | 2011-07-12 |
| 1831488477 | Karrie K Sweet | Dietitian, Registered | 161 Marginal Way, Portland, ME 04101 | 2011-04-05 |
| 1033363528 | Caitlin Phelps | Physician Assistant | 161 Marginal Way, Portland, ME 04101-2438 | 2008-11-10 |
| 1134325806 | Kate Forssell Kennedy | Internal Medicine | 161 Marginal Way, Portland, ME 04101-2438 | 2007-06-21 |
| 1891990602 | Daniil Rolshud | Internal Medicine | 161 Marginal Way, Portland, ME 04101-2438 | 2007-06-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1679199335 | Alter Image, Inc. | Specialist | 2340 Se Gladstone St, Portland, OR 97202-2962 | 2020-06-18 |
| 1770044281 | Donnissa Smith | Specialist | 117 Se 129th Ave, Portland, OR 97233-1503 | 2019-03-27 |
| 1588191258 | Jason Moore | Specialist | 522 Ne Thompson St, Portland, OR 97212-3843 | 2017-05-12 |
| 1578097218 | Alicia N Keys | Specialist | 10480 Sw Eastridge St Apt 88, Portland, OR 97225-5047 | 2017-04-19 |
| 1942734736 | Mom By Lj | Specialist | 2906 N Willamette Blvd, Portland, OR 97217-4073 | 2017-04-18 |
| 1659811198 | Ricardo H. Medina | Specialist | 1400 Nw Irving St Apt 709, Portland, OR 97209-2260 | 2017-03-02 |
| 1730626805 | Jennifer Frank | Specialist | 1008 Se 112th Ave, Portland, OR 97216-3516 | 2017-01-26 |
| 1720523012 | Andrea Lett | Specialist | 4627 Ne 30th Ave, Portland, OR 97211-7001 | 2016-12-22 |
| 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.