NPIMap

Organization Active NPI

Gifford Medical Center Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Randolph, VT
National Provider Identifier
1013928068
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
669 Issued in 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
Last updated
Jul 1, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GIFFORD MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Michael K Costa
Title
Ceo
Phone
(802) 728-2211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 669 VT Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210622000214 VT Part A Provider - Critical Access Hospital 4880683663 Practice locations: Randolph, VT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013928068. Details of each certification follow.

Hospital certification: CCN 47Z301

Legal name
GIFFORD MEDICAL CENTER INC
Organization structure
CorporationNon-profit
Incorporated
Jan 9, 1905 in VT
Enrollment address
44 S Main St
Randolph, VT 50601381
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Gifford Medical Ctr Inc

Locations

44 S Main St
Ste 1
Randolph, VT 05060
Phone (802) 728-2401

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kathleen Mason Individual Operational/Managerial ControlBoard Member Jan 1, 2026
Barbara J McKeon Individual Operational/Managerial ControlBoard Member Jan 1, 2026
Michael K Costa Individual Corporate DirectorChief Executive Officer Oct 3, 2024
W-2 Managing EmployeeChief Executive Officer Oct 3, 2024
Victor Ribaudo Individual Operational/Managerial ControlBoard Member Jan 1, 2026
Lucy Mize Individual Operational/Managerial ControlBoard Member Jan 1, 2026
Cheyenne Holland Individual Corporate OfficerChief Financial Officer Aug 19, 2024
Jeffrey J Nelb Individual Operational/Managerial ControlBoard Chair Jan 1, 2026
Kristin Chandler Individual Operational/Managerial ControlBoard Secretary Jan 1, 2026
Cindy Rosalbo Individual Operational/Managerial ControlBoard Member Jan 1, 2026
George J Silowash Individual Operational/Managerial ControlBoard Member Jan 1, 2026
Jerald a Ward Individual Operational/Managerial ControlBoard Member Jan 1, 2026
Morgan Rilling Individual Operational/Managerial ControlBoard Vice-Chair Jan 1, 2026
Jamie Kinnarney Individual Operational/Managerial ControlBoard Member Jan 1, 2026
Mark Andrews Individual Operational/Managerial ControlBoard Member Jan 1, 2026
Peter Reed Individual Corporate DirectorBoard Member Jan 28, 2016
Emilija O Florance Individual Operational/Managerial ControlBoard Member Jan 1, 2026

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 156

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.

View all 156

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1013928068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2000",
            "address_2": "44 SOUTH MAIN STREET",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050602000",
            "telephone_number": "802-728-7000",
            "fax_number": "802-728-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 S MAIN ST",
            "address_2": "BOX 2000",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050601381",
            "telephone_number": "802-728-7000",
            "fax_number": "802-728-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIFFORD MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GIFFORD MEDICAL CENTER",
        "enumeration_date": "2006-08-11",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "COSTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "802-728-2211"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "VT",
            "license": "669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, VT

Sources for this page

Verify at the official NPI Registry.