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JONATHAN CARL FELLERS MD NPI 1508091281


NPI Information

NPI: 1508091281
Provider Name: JONATHAN CARL FELLERS, MD
Classification: Psychiatry & Neurology - 2084P0802X
Entity Type: Individual

Specialization: Addiction Psychiatry

PECOS Registration: Yes

CLIA Number: 20D2166096

Address:
1 CITY CTR STE 8130
PORTLAND, ME
ZIP 04101
Phone: (207) 221-0635
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Jonathan Carl Fellers, MD is an addiction psychiatry psychiatry neurology in Portland, ME. The provider is addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. Jonathan Carl Fellers, MD NPI is 1508091281. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

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 NPI 1508091281 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 20D2166096 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/25/2009 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084P0802XPsychiatry & NeurologyAddiction PsychiatryMD20613MAINEYes
22084P0800XPsychiatry & NeurologyPsychiatryMD20613MAINENo
32083A0300XPreventive MedicineAddiction MedicineMD20613MAINENo

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.