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CASCO BAY DIRECT PRIMARY CARE
NPI 1679251946
Internal Medicine in South Portland, ME

Active since July 07, 2023CLIA 20D2288866 · Waiver
100 BRICKHILL AVE, SOUTH PORTLAND, ME 04106(207) 407-5027 Get Directions Write a Review

NPPES record last updated: July 7, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Casco Bay Direct Primary Care NPPES

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

CASCO BAY DIRECT PRIMARY CARE (NPI 1679251946) is a healthcare organization registered as an internal medicine in South Portland, Maine and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through August 31, 2027 and lists Jennifer Beall, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1679251946
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCASCO BAY DIRECT PRIMARY CARE
Location Address100 BRICKHILL AVESouth Portland, ME 04106-1999
Mailing Address80 Old Field RdYarmouth, ME 04096-7570 · (207) 776-0816
Phone(207) 407-5027
Organization SubpartNo
Authorized OfficialJennifer BeallPhysician/owner · (207) 407-5027
Enumeration DateJuly 7, 2023
NPPES CertifiedJuly 7, 2023
✔ NPI 1679251946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
100 BRICKHILL AVE, South Portland, ME 04106
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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 20D2288866

Casco Bay Direct Primary Care · South Portland, ME
Active · expires Aug 31, 2027
CLIA Number20D2288866
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2025
Certificate Expiration DateAugust 31, 2027
Laboratory DirectorJennifer K. Beall
Laboratory Phone(207) 407-5027
Laboratory LocationCasco Bay Direct Primary Care100 Brickhill Ave, South Portland, ME 04106
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

MARY C BRANDES MD
Obstetrics & Gynecology (Urogynecology and Reconstructive Pelvic Surgery)
100 BRICKHILL AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 761-1502
MS. MELISSA NYE LIBBY FNP
Nurse Practitioner (Family)
100 BRICKHILL AVE, STE 304
SOUTH PORTLAND, ME 04106
Cumberland County (207) 761-4700
LENOIR G KELLEY MSW-CC
Social Worker
100 BRICKHILL AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 874-2141
SYDNEY CHENEY DNP, FNP-BC
Nurse Practitioner (Family)
100 BRICKHILL AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 773-1728
ABBY ELIZABETH DAVIS LMT
Massage Therapist
100 BRICKHILL AVE, SUITE 301
SOUTH PORTLAND, ME 04106
Cumberland County (207) 879-7510
JULIE K BROWN LMT
Massage Therapist
100 BRICKHILL AVE, SUITE 301
SOUTH PORTLAND, ME 04106
Cumberland County (207) 879-7510
STEPHEN THOMAS RYAN MD
Urology
100 BRICKHILL AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 773-1728
KRISTEN M ROBINSON
Social Worker
100 BRICKHILL AVE
SOUTH PORTLAND, ME 04106
Cumberland County (207) 775-4101

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 Casco Bay Direct Primary Care's NPI number?

The NPI number for Casco Bay Direct Primary Care is 1679251946. It was assigned to this organization in the NPPES registry on July 7, 2023.

Where is Casco Bay Direct Primary Care located?

Casco Bay Direct Primary Care is located at 100 Brickhill Ave, South Portland, ME 04106. The listed phone number is (207) 407-5027.

What is Casco Bay Direct Primary Care's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Casco Bay Direct Primary Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D2288866) is associated with this NPI, valid through August 31, 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 Casco Bay Direct Primary Care was last updated on July 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.