Central Vermont Medical Center Inc

Organization Active NPI Family Medicine Physician · Berlin, VT

NPI 1023028784 · NPPES record last updated Feb 16, 2024

Key facts

NPI
1023028784
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
CENTRAL VERMONT MEDICAL CENTER INC
Practice address
130 Fisher Rd
Berlin, VT 05602-9516
Phone
(802) 371-4100
Fax
(802) 371-4488
NPI assigned
Aug 8, 2006
Organization subpart
Yes
Parent organization (as reported)
CVMC MEDICAL GROUP PRACTICES

Authorized official

Name
Cheyenne Holland
Title
Cfo
Phone
(802) 371-4109

Other NPIs with the same Medicare PAC ID 3

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

Practitioners 686

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 686

Medicare participation

Medicare fee-for-service enrollment
Enrolled (5 enrollments) in VT, NY, FL, NH, CO

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20051220000393 VT Part B Supplier - Clinic/Group Practice 9335138817 Receives reassigned benefits from 597 practitioners
Practice locations: Shelburne, VT; S Burlington, VT; Saint Albans, VT; South Burlington, VT; South Hero, VT; Underhill, VT; Waitsfield, VT; Waterbury, VT…
O20250827003491 NY Part B Supplier - Clinic/Group Practice 9335138817 Receives reassigned benefits from 5 practitioners
Practice locations: Rouses Point, NY; Plattsburgh, NY; Peru, NY; Glenmont, NY; Chazy, NY
O20250828002578 FL Part B Supplier - Clinic/Group Practice 9335138817 Receives reassigned benefits from 1 practitioner
Practice locations: Naples, FL
O20250829001904 NH Part B Supplier - Clinic/Group Practice 9335138817 Receives reassigned benefits from 2 practitioners
Practice locations: Hanover, NH; Lyme, NH
O20250908003021 CO Part B Supplier - Clinic/Group Practice 9335138817 Receives reassigned benefits from 1 practitioner
Practice locations: Denver, CO

National Provider Directory

Part of
Central Vermont Medical Center

Locations (25 of 35)

244 Granger Rd
Barre, VT 05641
Phone (802) 225-3942

50 Parkside Ter
Barre, VT 05641

246 Granger Rd
Ste 1
Barre, VT 05641
Phone (802) 371-5950

225 S Main St
Barre, VT 05641
Phone (802) 476-9242

246 Granger Road Berlin
Barre, VT 05641
Phone (802) 225-5810

246 Granger Rd
Ste 101
Barre, VT 05641

246 Granger Rd
Ste 203
Barre, VT 05641

246 Granger Rd
Ste 100
Barre, VT 05641

82 E View Ln
Ste 3
Barre, VT 05641
Phone (802) 225-1266

246 Granger Rd
Ste 2
Barre, VT 05641
Phone (802) 225-5810

130 Fisher Rd
Ste 4
Berlin, VT 05602
Phone (802) 371-4460

130 Fisher Rd
Ste 23
Berlin, VT 05602
Phone (802) 225-1750

130 Fisher Rd
Ste 1-1
Berlin, VT 05602
Phone (603) 653-9885

130 Fisher Rd
Ste 12
Berlin, VT 05602
Phone (802) 225-5400

130 Fisher Rd
Fl 2
Berlin, VT 05602
Phone (802) 371-5372

130 Fisher Rd
Ste 2
Berlin, VT 05602
Phone (802) 225-3980

130 Fisher Rd
Ste 1
Berlin, VT 05602
Phone (802) 371-4875

146 Woodridge Rd
Berlin, VT 05602

130 Fisher Rd
#A
Berlin, VT 05602
Phone (802) 225-5650

130 Fisher Rd
Ste 3MOBB
Berlin, VT 05602

195 Hospital Loop
Ste 2
Berlin, VT 05602

130 Fisher Rd
Fl 3
Berlin, VT 05602
Phone (802) 371-4316

130 Fisher Rd
Ste 3
Berlin, VT 05602
Phone (802) 225-3980

195 Hospital Loop
Ste 23
Berlin, VT 05602
Phone (802) 371-4875

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Cardiovascular Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RC0000X 762 VT
Endocrinology, Diabetes & Metabolism Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RE0101X 762 VT
Rheumatology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RR0500X
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207V00000X
Orthopaedic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207X00000X
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208000000X
Neurology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084N0400X VT
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084P0800X
Child & Adolescent Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084P0804X
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208600000X
Urology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208800000X
Podiatrist
Group: 193200000X MULTI-SPECIALTY GROUP
213E00000X

Addresses

Primary practice location

130 Fisher Rd
Berlin, VT 05602-9516

Mailing address

PO Box 547
Barre, VT 05641-0547
Phone (802) 371-4100

Other identifiers

IdentifierTypeStateIssuer
OVN3891MedicaidVT

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health

Other providers in Berlin, VT

All providers in Berlin, VT · Family Medicine Physician in Vermont

Sources for this page

Verify at the official NPI Registry.