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Deactivated NPI 1073522462 Deactivated / Inactive NPI Male Practitioner

C. Edward Staley , PA

Physician Assistant • Lincoln, ME

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, C. Edward Staley has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 05, 2006
NPI Deactivation Date February 28, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

C. Edward Staley, PA was a registered Physician Assistant practicing in Lincoln, ME. Throughout an active medical career spanning 13 years, C. Edward Staley provided care at the practice location at 175 WEST BROADWAY until profile deactivation on 2019-02-28.

Practice Location & Contact Primary Location

Practice Address

175 West Broadway

Lincoln, ME 044570000

Telephone 2077946700
Fax 2077946777
Associated Practice Facility / Clinic
🏢 Health Access Network, Inc Facility NPI 1467468215

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Lincoln, ME

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 37.5 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
9 Specialists

Practicing in Lincoln, ME (992 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License ME PA259

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Katherine Page , LCSW

Counselor - Mental Health

NPI 1023077286

Licensed Clinical Social Worker

Dr. Jerome Roberts , DDS

Dentist - General Practice

NPI 1023231271

Doctor of Dental Surgery

Thora House , FNP

Nurse Practitioner

NPI 1083673966

Family Nurse Practitioner

Tammy Webb , PA

Physician Assistant

NPI 1083826572

Physician Assistant

Dr. Paulo Antunes , MD

Family Medicine

NPI 1093831836

Doctor of Medicine (M.D.)

Joseph Aquilina , FNP-C

Nurse Practitioner - Family

NPI 1104835669

Family Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
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NPI Profile Deactivated February 28, 2019

Record deactivated on February 28, 2019

NPI Profile Active May 22, 2017

NPI status registered as active in NPPES database

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Updated Practice Location May 22, 2017

Registered at 175 W BROADWAY, LINCOLN, ME 044574000 (Tel: 2077946700)

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Updated Business Mailing Address May 22, 2017

Registered at PO BOX 99, LINCOLN, ME 044570099 (Tel: (207) 794-6700)

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Provider Name / Credentials Updated May 22, 2017

Recorded as C EDWARD STALEY, PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 22, 2017

Physician Assistant (License #PA259 in ME)

NPI Profile Active December 04, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location December 04, 2013

Registered at 175 WEST BROADWAY, LINCOLN, ME 044570000 (Tel: 2077946700)

📍
Updated Business Mailing Address December 04, 2013

Registered at PO BOX 99, LINCOLN, ME 044570099 (Tel: 2077946700)

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Provider Name / Credentials Updated December 04, 2013

Recorded as C. EDWARD STALEY, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 04, 2013

Physician Assistant (License #PA259 in ME)

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Initial NPI Registration & Enumeration August 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1073522462
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 05, 2006
Last Update: December 04, 2013
Deactivation Date: February 28, 2019

Mailing Address

Po Box 99

Lincoln, ME 044570099

Phone: 2077946700

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.