JONATHAN C FELLERS MD PA LLC NPI 1457823817

NPI Information

NPI: 1457823817
Provider Name: JONATHAN C FELLERS MD PA LLC

Doing Business As: CORTEX BEHAVIORAL HEALTH

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
1 CITY CTR STE 8130
PORTLAND, ME
ZIP 04101
Phone: (207) 221-0635
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JONATHAN C FELLERS MD PA LLC is a multi-specialty clinic center in Portland, ME. JONATHAN C FELLERS MD PA LLC NPI is 1457823817. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Cortex Behavioral Health.

The provider's business location address is:

1 CITY CTR STE 8130
PORTLAND, ME
ZIP 04101-420
Phone: (207) 221-0635
Fax: (207) 221-0634

The provider's authorized official is Jonathan C Fellers .
The authorized official title is Principal and has the following contact phone number (207) 221-0635.

The enumeration date for this NPI number is 12/26/2018 and was last updated on 12/26/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	101YM0800X	Counselor	Mental Health	No
3	207R00000X	Internal Medicine		No
4	2083A0300X	Preventive Medicine	Addiction Medicine	No
5	2084P0800X	Psychiatry & Neurology	Psychiatry	No
6	2084P0802X	Psychiatry & Neurology	Addiction Psychiatry	No
7	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	No
8	261QM1300X	Clinic/Center	Multi-Specialty	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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