Individual provider Active NPI

Kurt White

  • Clinical Social Worker
  • Brattleboro, VT
National Provider Identifier
1023111473
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089-0001107 Issued in VT
Practice address
Anna Marsh Lane
Brattleboro, VT 05302
Phone
(802) 257-7785
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089-0001107 VT Primary

Addresses

Primary practice location

Anna Marsh Lane
Brattleboro, VT 05302

Mailing address

Anna Marsh Lane
Brattleboro, VT 05302
Phone (802) 257-7785

Other identifiers 2

IdentifierTypeStateIssuer
089-0001107OtherVTLICENSE
1012660MedicaidVT

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060929000369 VT Practitioner - Clinical Social Worker 4587672142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brattleboro RetreatGroup PAC ID 7012828908, 61 clinicians

Practice addresses (Care Compare)

22 Anna Marsh LN
Dummerston, VT 05301-3292
Phone (802) 258-4391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
089-0001107VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brattleboro Retreat CurrentSince Nov 1, 2005 Accepting new patients
Brattleboro Retreat PastSince Nov 1, 2005 Accepting new patients

Locations

22 Anna Marsh Ln
Dummerston, VT 05301
Phone (802) 258-3700

1 Anna Marsh Ln
Dummerston, VT 05301

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1023111473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ANNA MARSH LANE",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "05302",
            "telephone_number": "802-257-7785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ANNA MARSH LANE",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "05302",
            "telephone_number": "802-257-7785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KURT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0001107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "089-0001107",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012660",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.