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WATERBORO VILLAGE PEDIATRICS LLC PA
NPI 1225018740
Pediatrics in East Waterboro, ME

Active since January 19, 2006CLIA 20D1014941 · Waiver
43 SOKOKIS TRAIL, EAST WATERBORO, ME 04030(207) 247-6742(207) 247-6114 Get Directions Write a Review

NPPES record last updated: May 7, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Waterboro Village Pediatrics Llc Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WATERBORO VILLAGE PEDIATRICS LLC PA (NPI 1225018740) is a healthcare organization registered as a pediatrics in East Waterboro, Maine and active in the NPI registry since January 2006. The organization holds a CLIA Waiver certificate valid through July 20, 2027 and lists Keasha Danielle Marescot, Co Owner Partner, as its authorized official.

NPPES Registry Identity

NPI1225018740
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameWATERBORO VILLAGE PEDIATRICS LLC PA
Location Address43 SOKOKIS TRAILEast Waterboro, ME 04030
Mailing AddressPo Box 1849Lewiston, ME 04241-1849 · (207) 784-2554 · Fax (207) 777-5363
Phone(207) 247-6742
Fax(207) 247-6114
Organization SubpartNo
Authorized OfficialKeasha Danielle MarescotCo Owner Partner · (207) 247-6742
Enumeration DateJanuary 19, 2006
Last NPPES UpdateMay 7, 2008
✔ NPI 1225018740 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
43 SOKOKIS TRAIL, East Waterboro, ME 04030
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Other Identifiers 2

Medicaid157150000ME
Medicaid30213870NH

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D1014941

Waterboro Village Pediatrics · East Waterboro, ME
Active · expires Jul 20, 2027
CLIA Number20D1014941
Laboratory TypePhysician Office
Certificate Effective DateJuly 21, 2025
Certificate Expiration DateJuly 20, 2027
Laboratory DirectorKeasha D. Grindley MD
Laboratory Phone(207) 793-2727
Laboratory LocationWaterboro Village Pediatrics43 Sokokis Trail PO Box 454, East Waterboro, ME 04030
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KEASHA DANIELLE MARESCOT MD
Pediatrics
43 SOKOKIS TRAIL
E WATERBORO, ME 04030
York County (207) 247-6742
MRS. ANN MARIE BROOKS MD
Pediatrics
43 SOKOKIS TRAIL
EAST WATERBORO, ME 04030
York County (207) 247-6742
MARY P WALSH DO
Pediatrics
43 SOKOKIS TRAIL
EAST WATERBORO, ME 04030
York County (207) 247-6742

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Waterboro Village Pediatrics LLC PA's NPI number?

The NPI number for Waterboro Village Pediatrics LLC PA is 1225018740. It was assigned to this organization in the NPPES registry on January 19, 2006.

Where is Waterboro Village Pediatrics LLC PA located?

Waterboro Village Pediatrics LLC PA is located at 43 Sokokis Trail, East Waterboro, ME 04030. The listed phone number is (207) 247-6742.

What is Waterboro Village Pediatrics LLC PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Waterboro Village Pediatrics LLC PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D1014941) is associated with this NPI, valid through July 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Waterboro Village Pediatrics LLC PA was last updated on May 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.