SHAW HOUSE (NPI# 1760575609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760575609 |
| Entity Type | Organization |
| Organization Name | SHAW HOUSE |
| Practice Address |
1048 Union St Ste 5 Bangor ME 04401-8601 |
| Mailing Address |
136 Union St Bangor ME 04401-6327 |
| Practice Telephone | 2079455247 |
| Practice Fax Number | 2079922154 |
| Mailing Telephone | 2079412882 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | THOMAS KOHL (CFO) |
| Authorized Official Telephone | 2079455247 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | SHAW HOUSE LLC | 24 Van Wyck Lane, Hudson, New York 12534 |
| Street Address |
1048 UNION ST STE 5 |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-8601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730282831 | Cavenaugh Kelly | Occupational Therapist | 1048 Union St Ste 5, Bangor, ME 04401-8601 | 2006-09-06 |
| 1912090846 | Manna Inc. | Family Medicine | 1048 Union St Ste 5, Bangor, ME 04401-8601 | 2006-10-02 |
| 1891887774 | Shaun Oconnor | Physician Assistant | 1048 Union St Ste 5, Bangor, ME 04401-8601 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225127905 | Lewis E Mehl-madrona | Family Medicine | 895 Union St Ste 12, Bangor, ME 04401-3054 | 2006-10-12 |
| 1831282771 | Penobscot Community Health Center | Family Medicine | 1048 Union St, Suite 5, Bangor, ME 04401-8600 | 2006-10-02 |
| 1659464584 | Penobscot Community Health Center | Family Medicine | 992 Union St. Suite J, Bangor, ME 04402 | 2006-10-02 |
| 1558370163 | David L Rocker | Family Medicine | 1012 Union Street, Bangor, ME 04401 | 2006-08-05 |
| 1194784991 | Noah Nesin | Family Medicine | 86 Davis Rd, Bangor, ME 04401-2311 | 2006-03-21 |
| 1619957966 | Ann L Holland | Family Medicine | 130 Cedar Street, Bangor, ME 04401 | 2006-01-20 |
| 1407847486 | Emily A. Burns | Family Medicine | 489 State St., Grant 6, Bangor, ME 04401 | 2005-10-31 |
| 1396734182 | Jessica Bloom-foster | Family Medicine | 895 Union St, Suite 12, Bangor, ME 04401-3053 | 2005-10-14 |
| 1154317626 | Francis J Cinelli | Family Medicine | 153 N 11th St, Bangor, PA 18013-1603 | 2005-09-21 |
| 1700886181 | Vaghenag Vahe Tarpinian | Family Medicine | 104 S 2nd St, Bangor, PA 18013-2504 | 2005-07-28 |
| Find all providers in BANGOR | ||||
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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.