Alice Cecile Pezzulich, FNP

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

0027640 Issued in VT

Practice address

9 Church St.
Arlington, VT 05250

Phone

(802) 375-6566

Fax

(802) 375-6828

NPI assigned

Sep 26, 2005

Last updated

Jun 23, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Alice Cecile Goodman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Michael Welther

  dba Arlington Family Practice

  • Family Medicine Physician
  • Arlington, VT
  • NPI 1982778189
  NPD (past)
• Dr. Joseph Christian Hadeed

  • Geriatric Medicine (Internal Medicine) Physician
  • Coral Springs, FL
  • NPI 1619134319
  NPD (past)

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1053307918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CHURCH STREET",
            "address_2": "PO BOX 690",
            "city": "ARLINGTON",
            "state": "VT",
            "postal_code": "052500690",
            "telephone_number": "802-375-6566",
            "fax_number": "802-375-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CHURCH ST.",
            "city": "ARLINGTON",
            "state": "VT",
            "postal_code": "05250",
            "telephone_number": "802-375-6566",
            "fax_number": "802-375-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZZULICH",
        "first_name": "ALICE",
        "middle_name": "CECILE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VT",
            "license": "0027640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS/TRICARE",
            "identifier": "GONP4075",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTHPLAN",
            "identifier": "696890",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "GONP4075",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ONP4075",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VERMONT BLUE CROSS",
            "identifier": "00059357",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0473830",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "414900",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICE",
            "last_name": "GOODMAN",
            "middle_name": "CECILE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Francis X Moriarty, ED.D.
• Jennifer Marie Moses, MS
• Ryan G. O'Connell, LCSW
• Denise Olin, PSY.D.
• Marisa Pagliccia, OTD, OTR/L
• Kimberly S Prins, PSY.D.
• Melissa J Prouty, FNP
• Kathryn Elizabeth Samuelson, RN
• Paula Miriam Shulman, LCSW LADC
• Katrina Snide

• Registered Nurse in Arlington, VT
• Providers in Arlington, VT by specialty
• Registered Nurse in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.