Paul Blakeslee, MS, RD-AP, LD, CNSC
Dietitian, Registered in Portland, ME. Individual provider (NPI-1).
NPI number1740089796
StatusActive
Last updated in NPPESMar 12, 2025
Details
- NPI
- 1740089796
- Entity type
- Individual (NPI-1)
- Name
- Mr. Paul Blakeslee
- Credential
- MS, RD-AP, LD, CNSC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 12, 2025
- Certification date
- Mar 12, 2025
- Last updated
- Mar 12, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | – | – | Yes |
Practice location
22 Bramhall StPortland, ME 04102-3134
Phone 207-662-5874
Mailing address
22 Bramhall St Dept OfPortland, ME 04102-3134
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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