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WATERVILLE PEDIATRICS PA
NPI 1790871994
Pediatrics in Waterville, ME

Active since October 05, 2006CLIA 20D0090256 · Waiver
295C KENNEDY MEMORIAL DR, WATERVILLE, ME 04901(207) 873-5437(207) 872-6037 Get Directions Write a Review

NPPES record last updated: April 2, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Apr 2, 2021, Aug 22, 2020 (2 updates tracked since 2020).

About Waterville Pediatrics Pa NPPES

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

WATERVILLE PEDIATRICS PA (NPI 1790871994) is a healthcare organization registered as a pediatrics in Waterville, Maine and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through March 31, 2028, maintains a secondary practice location in Waterville, and lists Jeffrey Stone, Treasurer, as its authorized official.

NPPES Registry Identity

NPI1790871994
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameWATERVILLE PEDIATRICS PA
Location Address295C KENNEDY MEMORIAL DRWaterville, ME 04901-4535
Mailing Address295c Kennedy Memorial DrWaterville, ME 04901-4535 · (207) 873-5437 · Fax (207) 872-6037
Phone(207) 873-5437
Fax(207) 872-6037
Organization SubpartNo
Authorized OfficialJeffrey StoneTreasurer · (207) 873-5437
Enumeration DateOctober 5, 2006
Last NPPES UpdateApril 2, 20212 updates tracked since enumeration
NPPES CertifiedApril 2, 2021
✔ NPI 1790871994 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in ME · 1317
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.
295C KENNEDY MEMORIAL DR, Waterville, ME 04901
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Secondary Practice Location 1

Location 1159 Silver StWaterville, ME 04901-5813 · Phone (207) 873-5437 · Fax (207) 872-6037

Other Identifiers 2

Other129440000ME · Mainecare Provider No.
Medicaid000206014ME

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 20D0090256

Mainegeneral Dba Waterville Pediatrics · Waterville, ME
Active · expires Mar 31, 2028
CLIA Number20D0090256
Laboratory TypePhysician Office
Certificate Effective DateApril 1, 2026
Certificate Expiration DateMarch 31, 2028
Laboratory DirectorDr. Melissa Taylor
Laboratory Phone(207) 873-5437
Laboratory LocationMainegeneral Dba Waterville Pediatrics295C Kennedy Memorial Drive Suite 1, Waterville, ME 04901
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 2

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

MRS. ANDERSON ELIZABETH CLEMENT FNP-C
Nurse Practitioner (Family)
295C KENNEDY MEMORIAL DR
WATERVILLE, ME 04901
Kennebec County (207) 873-5437
MS. ALLISON SCULLY CNP
Nurse Practitioner (Family)
295C KENNEDY MEMORIAL DR
WATERVILLE, ME 04901
Kennebec County (207) 873-5437

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 Waterville Pediatrics PA's NPI number?

The NPI number for Waterville Pediatrics PA is 1790871994. It was assigned to this organization in the NPPES registry on October 5, 2006.

Where is Waterville Pediatrics PA located?

Waterville Pediatrics PA is located at 295C Kennedy Memorial Dr, Waterville, ME 04901. The listed phone number is (207) 873-5437.

What is Waterville Pediatrics PA's specialty?

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

Does Waterville Pediatrics PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D0090256) is associated with this NPI, valid through March 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Waterville Pediatrics PA was last updated on April 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.