1831296748 NPI number — DR. BRETT S RANKIN MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831296748 NPI number — DR. BRETT S RANKIN MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

RANKIN

Provider First Name:

BRETT

Provider Middle Name:

S

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1831296748

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

04/12/2024

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

35 WALKER ST

Provider Second Line Business Mailing Address:

SUITE 200

Provider Business Mailing Address City Name:

KITTERY

Provider Business Mailing Address State Name:

ME

Provider Business Mailing Address Postal Code:

03904-1727

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

207-475-0100

Provider Business Mailing Address Fax Number:

207-351-3524

Provider First Line Business Practice Location Address:

35 WALKER ST

Provider Second Line Business Practice Location Address:

SUITE 200

Provider Business Practice Location Address City Name:

KITTERY

Provider Business Practice Location Address State Name:

ME

Provider Business Practice Location Address Postal Code:

03904-1727

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

207-475-0100

Provider Business Practice Location Address Fax Number:

207-351-3524

Provider Enumeration Date:

09/20/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207Y00000X , with the licence number:  11115 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207Y00000X , with the licence number: MD15457 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: MN4093 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
• Identifier: 000000027196 . This is a "BMC HEALTHNET" identifier . This identifiers is of the category "OTHER".
• Identifier: 8494087 . This is a "CIGNA (ALL STATES BUT NH)" identifier . This identifiers is of the category "OTHER".
• Identifier: 824187 . This is a "MARTINS POINT" identifier . This identifiers is of the category "OTHER".
• Identifier: 30212278 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
• Identifier: 363896 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 5896752 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
• Identifier: M2040700 . This is a "CIGNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 01Y002747ME01 . This is a "ANTHEM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
• Identifier: 104892900 . This is a "U.S. DEPT. OF LABOR-OWCP" identifier . This identifiers is of the category "OTHER".
• Identifier: 042172 . This is a "ANTHEM" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
• Identifier: 172160000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".