Madeline B Mann, NP
Individual provider Active NPI Family Nurse Practitioner · Milton, VT
NPI 1003075508 · NPPES record last updated Jun 30, 2023
Key facts
- NPI
- 1003075508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1010016208 (VT)
- Practice address
- 11 Haydenberry Dr
Milton, VT 05468-2200 - Phone
- (802) 846-1200
- NPI assigned
- Jun 9, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120723000463 | VT | Practitioner - Nurse Practitioner | 0547426496 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1010016208 | VT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Care Health Partners - New York LLP | Current |
Accepting new patients | |
| Primary Care Health Partners | Past | Accepting new patients |
Locations
600 Blair Park Rd
Ste 285
Williston, VT 05495
Phone (802) 288-1140
66 Knight Ln
Ste 10
Williston, VT 05495
Phone (802) 872-4327
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1010016208 | VT | Yes |
Addresses
Primary practice location
11 Haydenberry Dr
Milton, VT 05468-2200
Mailing address
600 Blair Park Rd Ste 285
Williston, VT 05495-7586
Phone (802) 288-1140
Other practice location 1
51 Timber Ln
South Burlington, VT 05403-5201
Phone (802) 864-0521
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1015415 | Medicaid | VT |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mmann@pcphmd.medentdirect.com | Direct |
Other providers in Milton, VT
- Charles Robert Litchfield
- David N Little
- Rachel Wellman Look
- Kimberly Jean Lord
- Meaghan Magner
- Martins Foods of South Burlington LLC
- Jane McClelland
- Kari Joan McKinley
- Annie Salene Mell
- Milton Chiropractic Center
All providers in Milton, VT · Family Nurse Practitioner in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.