Gifford Medical Center Inc
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Randolph, VT
NPI 1013928068 · NPPES record last updated Jul 1, 2025
Key facts
- NPI
- 1013928068
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- License
- 669 (VT)
- Legal business name
- GIFFORD MEDICAL CENTER INC
- Practice address
- 44 S Main St
Box 2000
Randolph, VT 05060-1381 - Phone
- (802) 728-7000
- Fax
- (802) 728-2394
- NPI assigned
- Aug 11, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- GIFFORD MEDICAL CENTER
Authorized official
- Name
- Michael K Costa
- Title
- Ceo
- Phone
- (802) 728-2211
Owners & managing parties with NPI records 1
Other NPIs with the same Medicare PAC ID 2
Related certifications (CCN) 1
Practitioners 172
-
Nicolas R Benoit, D.P.M.
-
Jonathan Edward Bjork, D.P.M.
-
Kenneth G Borie, M.D.
-
Ovleto W. Ciccarelli, M.D.
-
John Andrew Dreslin, M.D.
-
Rachel Spengler, PA-C
-
Michelle Ann Wade, ARNP
-
Joshua White, MD
-
Syed Akbar, MD
-
Bruce Wayne Andrus, M.D.
-
Tse Anyu, DO
-
Antonio Ciccone, DO
-
Shola A Cole, MD
-
Melanie Lynn Del Frari, APRN
-
Alexander Macrae Harvin, M.D.
-
Dawn Holman, M.D.
-
Robert T. Howard III, M.D.
-
Karen A Jobalia, MD
-
Sarah Joel Kantharia, M.D.
-
Steven J Karidas, MD
-
Tejal M Lalaji, MD
Affiliated clinicians 7
-
Richard Gerald Taylor, M.D.
-
Michelle Ann Wade, ARNP
-
Melanie Lynn Del Frari, APRN
-
Patricia Lynn Murphy, MSN, FNP-BC
-
Kerin D Vadnais, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Hospital certification: CCN 47Z301
- Legal name
- GIFFORD MEDICAL CENTER INC
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 9, 1905 in VT
- Enrollment address
- 44 S Main St
Randolph, VT 50601381
All disclosed owners & managing parties 16
| Name | Role | Since | Share |
|---|---|---|---|
| Kathleen Mason |
Operational/Managerial Control |
Jan 1, 2026 | |
| Barbara J McKeon |
Operational/Managerial Control |
Jan 1, 2026 | |
| Michael K Costa |
Corporate Director |
Oct 3, 2024 | |
| W-2 Managing Employee |
Oct 3, 2024 | ||
| Victor Ribaudo |
Operational/Managerial Control |
Jan 1, 2026 | |
| Lucy Mize |
Operational/Managerial Control |
Jan 1, 2026 | |
| Cheyenne Holland |
Corporate Officer |
Aug 19, 2024 | |
| Jeffrey J Nelb |
Operational/Managerial Control |
Jan 1, 2026 | |
| Kristin Chandler |
Operational/Managerial Control |
Jan 1, 2026 | |
| Cindy Rosalbo |
Operational/Managerial Control |
Jan 1, 2026 | |
| George J Silowash |
Operational/Managerial Control |
Jan 1, 2026 | |
| Jerald a Ward |
Operational/Managerial Control |
Jan 1, 2026 | |
| Morgan Rilling |
Operational/Managerial Control |
Jan 1, 2026 | |
| Jamie Kinnarney |
Operational/Managerial Control |
Jan 1, 2026 | |
| Mark Andrews |
Operational/Managerial Control |
Jan 1, 2026 | |
| Peter Reed |
Corporate Director |
Jan 28, 2016 | |
| Emilija O Florance |
Operational/Managerial Control |
Jan 1, 2026 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210622000214 | VT | Part a Provider - Critical Access Hospital | 4880683663 | Practice locations: Randolph, VT |
National Provider Directory
- Part of
- Gifford Pediatric Inter
Locations
44 S Main St
#2000
Randolph, VT 05060
Phone (802) 728-7000
1422 Vt Route 66
Randolph, VT 05060
Phone (802) 728-7742
44 S Main St
Ste 1
Randolph, VT 05060
Phone (802) 728-2401
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 669 | VT | Yes |
Addresses
Primary practice location
44 S Main St
Box 2000
Randolph, VT 05060-1381
Mailing address
PO Box 2000
44 South Main Street
Randolph, VT 05060-2000
Phone (802) 728-7000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 047Z301 | Medicaid | VT |
Other providers in Randolph, VT
- Gifford Medical Center
- Gifford Medical Center
- Gifford Medical Center
- Gifford Medical Center
- Gifford Medical Center
- Gifford Medical Center Inc
- Gifford Medical Center Inc.
- Gifford Retirement Community, Inc
- Emma Gillette
- Dennis Gilroy
All providers in Randolph, VT · Medicare Defined Swing Bed Hospital Unit in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2025. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.