PENOBSCOT NATION HEALTH DEPARTMENT
NPI 1801101993
Clinic/Center in Indian Island, ME
NPI Status: Active since August 12, 2010
Contact Information
23 WABANAKI WAY
INDIAN ISLAND, ME
ZIP 04468
Phone: (207) 817-7400
Fax: (207) 817-7459
- Organization
- Clinic/Center
- CLIA Number: 20D0719653
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 10-15-2026
About PENOBSCOT NATION HEALTH DEPARTMENT
This page provides the complete NPI Profile along with additional information for Penobscot Nation Health Department, a provider established in Indian Island, Maine operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1801101993 assigned on August 2010. The practitioner's primary taxonomy code is 261Q00000X with license number 12011471A (IN). The provider is registered as an organization and their NPI record was last updated 15 years ago. The authorized official of this NPI record is Jill P Macdougall (Intern Director)
- NPI
- 1801101993
- Provider Name
- PENOBSCOT NATION HEALTH DEPARTMENT
- Entity Type
- Organization
- Location Address
- 23 WABANAKI WAY INDIAN ISLAND, ME 04468
- Location Phone
- (207) 817-7400
- Location Fax
- (207) 817-7459
- Mailing Address
- 23 WABANAKI WAY INDIAN ISLAND, ME 04468
- Mailing Phone
- (207) 817-7400
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-12-2010
- Last Update Date
- 08-12-2010
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License No.
- 12011471A
- License State
- IN
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 20D0719653
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- October 16, 2024
- Certificate Expiration Date
- October 15, 2026
- Laboratory Director
- BENJAMIN W. HUERTH MD
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Penobscot Nation Health Department in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 8 | 0 | 1 | 1 | 0 | 1 | 9 | 9 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 0 | 1 | 2 | 0 | 2 | 9 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 0 + 1 + 2 + 0 + 2 + 9 + 1 + 8 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1801101993 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1679578025 | MR. LESLIE MAXWELL OHMART III RPH Individual | Pharmacist | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7435 |
| 1013095082 | MS. WINONA ALICE NICOLAR Individual | Pharmacy Technician | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1588742530 | MS. NITISHA LYNE MITCHELL Individual | Pharmacy Technician | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1770661134 | MS. APRIL LEE EWER Individual | Pharmacy Technician | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1952489379 | DR. PUSHPINDER D SINGH DDS Individual | Dentist (General Practice) | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1750450896 | MARIE MITCHELL LCPC, CADC Individual | Counselor | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1275602922 | DR. JOHN NMN YASENCHAK ED. D Individual | Counselor | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1588733257 | MEREDITH M BRUSKIN FNP Individual | Nurse Practitioner (Family) | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1770652059 | MS. ANDREA J. MIETKIEWICZ RN Individual | Registered Nurse | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1801968391 | MR. DALE E LOLAR LADC Individual | Counselor | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7425 |
| 1407928831 | MS. DONNA L HARRIS Individual | Dental Hygienist | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1700950466 | MS. SUSAN B. JUDSON-PREBLE RDH Individual | Dental Hygienist | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1457427841 | MR. TIMOTHY R. LENTZ FNP Individual | Nurse Practitioner (Family) | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1033277678 | MS. TANYA M MILLER RN Individual | Registered Nurse | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1225153851 | MARGO DOWNING RN Individual | Registered Nurse | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7433 |
| 1568673267 | MERLA ROY Individual | Technician, Pathology (Phlebotomy) | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1467658112 | BENJAMIN WALTER HUERTH MD Individual | Family Medicine | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7400 |
| 1013187061 | PAUL DEAN FLAGG R.PH. Individual | Pharmacist | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7435 |
| 1639139140 | PENOBSCOT INDIAN NATION FINANCE OFFICE Organization | Clinic/Center (Rural Health) | 23 WABANAKI WAY INDIAN ISLAND, ME 04468 (207) 817-7404 |
| 1679570188 | DR. EDWARD N. ROBERTSON DMD,MS Individual | Dentist | 23 WABANAKI WAY PENOBSCOT NATION HEALTH DEPARTMENT INDIAN ISLAND, ME 04468 (207) 817-7418 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1801101993, enumerated in the NPI registry as an "organization" on August 12, 2010
The provider is located at 23 Wabanaki Way Indian Island, Me 04468 and the phone number is (207) 817-7400
This medical organization specializes in Clinic/Center with taxonomy code 261Q00000X
The provider's CLIA number is 20D0719653 for a "federally qualified health center" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on August 12, 2010. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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