NPIMap

Organization Active NPI

Rebecca a Foulk MD PC

Doing business as South Royalton Health Center

  • Pediatrics Physician
  • South Royalton, VT
National Provider Identifier
1003834664
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
REBECCA A FOULK MD PC
Doing business as
South Royalton Health Center
Practice address
79 South Windsor Street
South Royalton, VT 05068
Phone
(802) 763-7575
Fax
(802) 763-2190
NPI assigned
Jul 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Rebecca Ann Foulk, MDNPI 1154353274
Title
President Director
Phone
(802) 763-7575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

79 South Windsor Street
South Royalton, VT 05068

Mailing address

PO Box 119
South Royalton Health Center
South Royalton, VT 05068
Phone (802) 763-7575

Other identifiers 2

IdentifierTypeStateIssuer
1011095MedicaidVT
30214261MedicaidNH

Other names 1

  • South Royalton Health Center 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
47D0090610South Royalton Health Center79 South Windsor St, South Royalton, VT 05068Certificate of waiverSep 29, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003834664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 119",
            "address_2": "SOUTH ROYALTON HEALTH CENTER",
            "city": "SOUTH ROYALTON",
            "state": "VT",
            "postal_code": "05068",
            "telephone_number": "802-763-7575",
            "fax_number": "802-763-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 SOUTH WINDSOR STREET",
            "city": "SOUTH ROYALTON",
            "state": "VT",
            "postal_code": "05068",
            "telephone_number": "802-763-7575",
            "fax_number": "802-763-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBECCA A FOULK MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOULK",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT DIRECTOR",
        "authorized_official_telephone_number": "802-763-7575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011095",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30214261",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Royalton Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Royalton, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.