Abigail Rose Brown, PA-C
Individual provider Active NPI Physician Assistant · Rutland, VT
NPI 1013938992 · NPPES record last updated May 28, 2021
Key facts
- NPI
- 1013938992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 055.0031067 (VT)
- Practice address
- 173 S Main St
Rutland, VT 05701-4713 - Phone
- (802) 772-4165
- Fax
- (802) 855-8489
- NPI assigned
- Jul 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Oklahoma College of Medicine, 2005
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Clearchoicemd, PLLC
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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101109000569 | VT | Practitioner - Physician Assistant | 5597761270 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055.0031067 | VT | MD | Physician Assistant |
| 2244 | CO | MD | Medical Physician Assistant |
| 055-0031067 | VT | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clearchoicemd, PLLC | Current |
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
#2
Barre, VT 05641
Phone (802) 744-0138
798 US Route 302
Barre, VT 05641
Phone (802) 223-4200
173 S Main St
Rutland, VT 05701
Phone (802) 722-4165
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 055-0031067 | VT | |
| Medical Physician Assistant | 363AM0700X | 2244 | CO | |
| Physician Assistant | 363A00000X | 055.0031067 | VT | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44485018 | Medicaid | CO | |
| 9000489 | Medicaid | VT |
Other providers in Rutland, VT
- Stephen M Brittain
- Emily Brooks
- Jennifer A Broomfield
- Katherine Mary Brower
- Lori M Brown-Stone
- Alyssa Mary Brown
- Krystal J Brown
- Lisa E Brown
- Nusi Peczi Brown
- Patricia Densberger Brown
All providers in Rutland, VT · Physician Assistant in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2021. 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.
- Order and Referring (CMS).
- 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.