Organization Active NPI

Green Mountain Pediatrics PC

  • Pediatrics Physician
  • Bennington, VT
National Provider Identifier
1073617783
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GREEN MOUNTAIN PEDIATRICS PC
Practice address
901 Main Street
Suite 1
Bennington, VT 05201
Phone
(802) 442-6057
Fax
(802) 447-1348
NPI assigned
Sep 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Judy K Orton, MD PANPI 1346309473
Title
President Director
Phone
(802) 442-6057

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
Pediatrics Physician 208000000X VT Primary

Addresses

Primary practice location

901 Main Street
Suite 1
Bennington, VT 05201

Mailing address

901 Main Street
Suite 1
Bennington, VT 05201
Phone (802) 442-6057

Other identifiers 5

IdentifierTypeStateIssuer
10017477OtherCDPHP
0427959OtherCIGNA
26188OtherMVP
1006759MedicaidVT
33748798OtherVTBCBS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
47D0090766Green Mountain Pediatrics PC901 Main St, Bennington, VT 05201Certificate of waiverDec 29, 2026

National Provider Directory

National Provider Directory

Locations

901 Main St
#1
Bennington, VT 05201
Phone (802) 442-6057

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073617783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MAIN STREET",
            "address_2": "SUITE 1",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "05201",
            "telephone_number": "802-442-6057",
            "fax_number": "802-447-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MAIN STREET",
            "address_2": "SUITE 1",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "05201",
            "telephone_number": "802-442-6057",
            "fax_number": "802-447-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN MOUNTAIN PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ORTON",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT DIRECTOR",
        "authorized_official_telephone_number": "802-442-6057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10017477",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0427959",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "26188",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006759",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "33748798",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bennington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.