Verne L Backus, M.D., M.P.H.

Individual provider Active NPI Specialist · Swanton, VT

NPI 1013014489 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1013014489
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
042-0009809 (VT)
Practice address
260 Crest Rd, Ste 101
Swanton, VT 05488
Phone
(802) 524-1223
Fax
(802) 524-1095
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0009809VTMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center, Inc. Past
since Oct 8, 2008
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 042-0009809 VT Yes

Addresses

Primary practice location

260 Crest Rd, Ste 101
Swanton, VT 05488

Mailing address

260 Crest Rd, Ste 101
Swanton, VT 05488
Phone (802) 524-1223

Other identifiers

IdentifierTypeStateIssuer
39665OtherVTBLUE CROSS PROVIDER NUMBE
5734535OtherVTCIGNA PROVIDER NUMBER
740518OtherVTMVP PROVIDER NUMBER

Other providers in Swanton, VT

All providers in Swanton, VT · Specialist in Vermont

Sources for this page

Verify at the official NPI Registry.