Organization Active NPI

Stowe Personalized Medical Care PLLC

  • Family Medicine Physician
  • Stowe, VT
National Provider Identifier
1033544358
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042.0007377 Issued in VT
Legal business name
STOWE PERSONALIZED MEDICAL CARE PLLC
Practice address
53 Old Farm Road
Stowe, VT 05672-0357
Phone
(802) 253-5020
Fax
(802) 253-5021
NPI assigned
Sep 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

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

Authorized official

Name
Dr. David Bisbee, M.D.NPI 1871598722
Title
Owner
Phone
(802) 253-5020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 042.0007377 VT Primary

Addresses

Primary practice location

53 Old Farm Road
Stowe, VT 05672-0357

Mailing address

PO Box 357
53 Old Farm Road
Stowe, VT 05672-0357
Phone (802) 253-5020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131207000003 VT Part B Supplier - Clinic/Group Practice 1153558655 Receives reassigned benefits from 1 practitioner
Practice locations: Stowe, VT

National Provider Directory

National Provider Directory

Locations

166 S Main St
Unit 1B
Stowe, VT 05672
Phone (802) 253-5020

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1378339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394755200000",
    "number": "1033544358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 357",
            "address_2": "53 OLD FARM ROAD",
            "city": "STOWE",
            "state": "VT",
            "postal_code": "056720357",
            "telephone_number": "802-253-5020",
            "fax_number": "802-253-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 OLD FARM ROAD",
            "city": "STOWE",
            "state": "VT",
            "postal_code": "056720357",
            "telephone_number": "802-253-5020",
            "fax_number": "802-253-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOWE PERSONALIZED MEDICAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-05",
        "last_updated": "2014-03-14",
        "status": "A",
        "authorized_official_last_name": "BISBEE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-253-5020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042.0007377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stowe, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.