Richard Andrew Burgoyne, M.D.
Individual provider Active NPI Family Medicine Physician · Waterbury, VT
NPI 1093745580 · NPPES record last updated Dec 4, 2014
Key facts
- NPI
- 1093745580
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0420011847 (VT)
- Practice address
- 130 S Main St
Waterbury, VT 05676-1519 - Phone
- (802) 244-7874
- Fax
- (802) 244-4106
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0042816 | MD | MD | Family Medicine Physician |
| 0420011847 | VT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Vermont Medical Center Inc | Family Medicine | Current |
Accepting new patients |
| Central Vermont Medical Center Inc | Family Medicine | Current |
Accepting new patients |
Locations
77 Vine St
Barre, VT 05641
Phone (802) 225-1266
130 Fisher Rd
Barre, VT 05641
Phone (802) 371-4235
130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400
130 S Main St
Waterbury, VT 05676
Phone (802) 244-7874
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D0042816 | MD | |
| Family Medicine Physician | 207Q00000X | 0420011847 | VT | Yes |
Addresses
Primary practice location
130 S Main St
Waterbury, VT 05676-1519
Mailing address
PO Box 547
Central Vermont Medical Center - Finance Dept
Barre, VT 05641-0547
Phone (802) 244-7874
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 751121300 | Medicaid | MD | |
| 1016787 | Medicaid | VT |
Other providers in Waterbury, VT
- Louis Bevacqui
- Christine Cameron Blake
- Merton R. Boardman Sr.
- Brain Injury Alliance of Vermont
- Carol L Buck-Rolland
- Katharina Cahill
- Craig A Cammann
- Laurie A. Carcieri
- Alison Chick
- Chloe Rose Smith, PLLC
All providers in Waterbury, VT · Family Medicine Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.