| Dfd Russell Medical Center Inc | |
|
180 Church Hill Rd Suite 1 Leeds ME 04263-3418 | |
| (207) 524-3501 | |
| (207) 524-2459 |
| Full Name | Dfd Russell Medical Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 180 Church Hill Rd, Leeds, Maine |
| Authorized Official Name and Position | Laurie A Kane-lewis (CEO) |
| Authorized Official Contact | 2075243501 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dfd Russell Medical Center Inc 180 Church Hill Rd Suite 1 Leeds ME 04263-3418 Ph: (207) 524-3501 | Dfd Russell Medical Center Inc 180 Church Hill Rd Suite 1 Leeds ME 04263-3418 Ph: (207) 524-3501 |
| NPI Number | 1952482804 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 02/09/2024 |
| Medicare PECOS PAC ID | 3274502000 |
|---|---|
| Medicare Enrollment ID | O20040929000224 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952482804 | NPI | - | NPPES |
| 168270000 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Maine) | Primary |
| Provider Name | Robin Rockett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851355358 PECOS PAC ID: 1658345731 Enrollment ID: I20040824000824 |
| Provider Name | Laurie A Huntress |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629046693 PECOS PAC ID: 4587613203 Enrollment ID: I20050119000896 |
| Provider Name | Peggy Wyman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073592283 PECOS PAC ID: 8729020748 Enrollment ID: I20050531000551 |
| Provider Name | Trisha A Gushue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942289657 PECOS PAC ID: 5597709261 Enrollment ID: I20050614000343 |
| Provider Name | Lydia Thorp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801875018 PECOS PAC ID: 5799673356 Enrollment ID: I20051019000199 |
| Provider Name | Deborah C Guilmette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649495599 PECOS PAC ID: 1759489867 Enrollment ID: I20070612000840 |
| Provider Name | Gary S Rivard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194801993 PECOS PAC ID: 3870649973 Enrollment ID: I20090915000174 |
| Provider Name | Leslie Bradbury |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952749723 PECOS PAC ID: 7416180161 Enrollment ID: I20161017002547 |
| Provider Name | Amanda N Milliken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629511969 PECOS PAC ID: 5395026777 Enrollment ID: I20161222001032 |
| Provider Name | Jennifer Alexander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306273917 PECOS PAC ID: 6901164243 Enrollment ID: I20171214002658 |
| Provider Name | Megan Marie Day |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912299397 PECOS PAC ID: 4688913403 Enrollment ID: I20190222000029 |
| Provider Name | Jennifer L Michaud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144853318 PECOS PAC ID: 7911336623 Enrollment ID: I20200401000617 |
| Provider Name | Christopher Raymond Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699322859 PECOS PAC ID: 2567873201 Enrollment ID: I20201201001910 |
| Provider Name | Bridget Ross-fitzgibbons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144688102 PECOS PAC ID: 2961782826 Enrollment ID: I20210729003651 |
| Provider Name | Heather Lynn Errington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487231932 PECOS PAC ID: 8921496076 Enrollment ID: I20211022001652 |
| Provider Name | Brianna A. Palmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295587509 PECOS PAC ID: 2264872639 Enrollment ID: I20240502000517 |