NPI Code Detail JSON Logo

1336179084 NPI number — REDINGTON MEDICAL ASSOCIATES

NPI Number: 1336179084
Health Care Provider/Practitioner: REDINGTON MEDICAL ASSOCIATES

Information about “1336179084” NPI (REDINGTON MEDICAL ASSOCIATES) exists in 1336179084 in HTML format HTML  |  1336179084 in plain Text format TXT  |  1336179084 in PDF (Portable Document Format) PDF  |  1336179084 in an XML format XML  formats.

NPI Number : 1336179084 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1336179084",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "REDINGTON MEDICAL ASSOCIATES",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 957",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SKOWHEGAN",
    "MailingAddressStateName": "ME",
    "MailingAddressPostalCode": "04976-0957",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "207-474-6940",
    "MailingAddressFaxNumber": "207-474-6940",
    "FirstLinePracticeLocationAddress": "57 FAIRVIEW AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SKOWHEGAN",
    "PracticeLocationAddressStateName": "ME",
    "PracticeLocationAddressPostalCode": "04976-1403",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "207-474-6940",
    "PracticeLocationAddressFaxNumber": "207-474-6940",
    "EnumerationDate": "07/04/2006",
    "LastUpdateDate": "09/11/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LEADBETTER",
    "AuthorizedOfficialFirstName": "RAYMOND",
    "AuthorizedOfficialMiddleName": "J",
    "AuthorizedOfficialTitle": "PRACTICE MANAGER",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": "JR.",
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "207-474-6940",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RG0100X",
          "TaxonomyName": "Gastroenterology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207X00000X",
          "TaxonomyName": "Orthopaedic Surgery Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208000000X",
          "TaxonomyName": "Pediatrics Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208600000X",
          "TaxonomyName": "Surgery Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084N0400X",
          "TaxonomyName": "Neurology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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