NPIMap

Organization Active NPI

Northwestern Medical Center, Inc.

Doing business as Northwestern Associates In Surgery

  • Surgery Physician
  • Saint Albans, VT
National Provider Identifier
1003118563
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NORTHWESTERN MEDICAL CENTER, INC.
Doing business as
Northwestern Associates In Surgery
Practice address
1 Crest Rd
Suite B
Saint Albans, VT 05478-9753
Phone
(802) 524-8974
Fax
(802) 524-8970
NPI assigned
Dec 3, 2010
Last updated
Oct 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary Pigeon
Title
Credentialing Specialist
Phone
(802) 524-8954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

1 Crest Rd
Suite B
Saint Albans, VT 05478-9753

Mailing address

1 Crest Rd
Suite B
Saint Albans, VT 05478-9753
Phone (802) 524-8974

Other identifiers 1

IdentifierTypeStateIssuer
1018505MedicaidVT

Other names 1

  • Northwestern Associates In Surgery Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
47D2019165Northwestern Associates in Surgery1 Crest Road, Ste B, St Albans, VT 05478Certificate of waiverJan 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Northwestern Medical Ce36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Locations

1 Crest Rd
Ste B
Saint Albans, VT 05478
Phone (802) 524-8974

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1003118563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CREST RD",
            "address_2": "SUITE B",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054789753",
            "telephone_number": "802-524-8974",
            "fax_number": "802-524-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CREST RD",
            "address_2": "SUITE B",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054789753",
            "telephone_number": "802-524-8974",
            "fax_number": "802-524-8970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "PIGEON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "802-524-8954"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018505",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwestern Associates In Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Albans, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.