Individual provider Active NPI

Abigail Rose Brown, PA-C

  • Physician Assistant
  • Rutland, VT
National Provider Identifier
1013938992
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
055.0031067 Issued in VT
Practice address
173 S Main St
Rutland, VT 05701-4713
Phone
(802) 772-4165
Fax
(802) 855-8489
NPI assigned
Jul 23, 2006
Last updated
May 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 055-0031067 VT
Medical Physician Assistant 363AM0700X 2244 CO
Physician Assistant 363A00000X 055.0031067 VT Primary

Addresses

Primary practice location

173 S Main St
Rutland, VT 05701-4713

Mailing address

74 Pleasant St
Ste 204
New London, NH 03257-5881
Phone (802) 772-4165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101109000569 VT Practitioner - Physician Assistant 5597761270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Oklahoma College of Medicine, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Clearchoicemd, PLLCGroup PAC ID 1850510058, 85 clinicians

Practice addresses (Care Compare)

1200 Williston Rd
South Burlington, VT 05403-5720
Phone (603) 526-4635

62 Merchants Row
Williston, VT 05495-4476
Phone (802) 307-1200

798 US Route 302
Unit 2
Barre, VT 05641-2305
Phone (603) 526-4635

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2244COMDMedical Physician Assistant
055-0031067VTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Clearchoicemd, PLLC CurrentSince May 21, 2021 Accepting new patients
Clearchoicemd Primary Care PLLC Past Accepting new patients

Locations

74 Pleasant St
Ste 204
New London, NH 03257

798 US Route 302
Barre, VT 05641
Phone (802) 223-4200

798 US Route 302
#2
Barre, VT 05641
Phone (802) 744-0138

173 S Main St
Rutland, VT 05701
Phone (802) 772-4165

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1013938992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 PLEASANT ST",
            "address_2": "STE 204",
            "city": "NEW LONDON",
            "state": "NH",
            "postal_code": "032575881",
            "telephone_number": "802-772-4165",
            "fax_number": "802-855-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 S MAIN ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014713",
            "telephone_number": "802-772-4165",
            "fax_number": "802-855-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ABIGAIL",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-23",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VT",
            "license": "055-0031067",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "2244",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.