Champlain Medical Associates PLLC
Organization Active NPI Family Medicine Physician · S Burlington, VT
NPI 1013273697 · NPPES record last updated Jan 31, 2014
Key facts
- NPI
- 1013273697
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CHAMPLAIN MEDICAL ASSOCIATES PLLC
- Practice address
- 150 Kennedy Dr
S Burlington, VT 05403-6749 - Phone
- (802) 448-9370
- Fax
- (802) 448-1414
- NPI assigned
- Apr 8, 2012
- Organization subpart
- No
Authorized official
- Name
- Beth Schiller
- Title
- Partner
- Phone
- (518) 963-4355
Practitioners 17
-
Beth Schiller, AGNP
-
Jonathon Cahoon, PA-C
-
Aisha Hussain, PA
-
Lianna Ruth Percy, PA-C
-
Alexis Brooke Saaman, PA-C
-
Courtneyanne Randall, PA-C
-
Molly G Somaini, PA-C
-
Jessica Rennie Alexander, PHYSICAL THERAPIST
-
Andrea Lemnah, P.T.
-
Candace Bennett, DPT
-
Tracy Titchner, PT
-
Carolyn R Weber, PT
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 47D2041266 | Champlain Medical Associates | Certificate of waiver | May 20, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120618000283 | VT | Part B Supplier - Clinic/Group Practice | 4981868247 |
Receives reassigned benefits from 8 practitioners Practice locations: South Burlington, VT |
National Provider Directory
Locations
150 Kennedy Dr
Ste 3
South Burlington, VT 05403
Phone (802) 448-9370
150 Kennedy Dr
South Burlington, VT 05403
Phone (802) 448-9370
265 Aviation Ave
South Burlington, VT 05403
Phone (855) 262-6789
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
150 Kennedy Dr
S Burlington, VT 05403-6749
Mailing address
150 Kennedy Dr
S Burlington, VT 05403-6749
Other providers in S Burlington, VT
- Tina L Bleau
- Bruce A Brown
- Stephanie A. Burch
- Douglas M. Campbell
- Cara M. Capparelli
- Sara T. Child
- Stewart Leslie Cohen
- Cole Vision Corporation
- Dana Lukens Dabransky
- David Huesman Inc
All providers in S Burlington, VT · Family Medicine Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2014. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.