Mad River Integrative Medicine

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

042-0007289 Issued in VT

Legal business name

MAD RIVER INTEGRATIVE MEDICINE

Practice address

5360 Main St
Ste 2
Waitsfield, VT 05673-6003

Phone

(802) 496-2202

Fax

(802) 496-2223

NPI assigned

Dec 8, 2006

Last updated

Apr 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Timothy J Wargo, M.D

Title

President

Phone

(802) 496-2202

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1114086808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5360 MAIN ST",
            "address_2": "STE 2",
            "city": "WAITSFIELD",
            "state": "VT",
            "postal_code": "056736003",
            "telephone_number": "802-496-2202",
            "fax_number": "802-496-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5360 MAIN ST",
            "address_2": "STE 2",
            "city": "WAITSFIELD",
            "state": "VT",
            "postal_code": "056736003",
            "telephone_number": "802-496-2202",
            "fax_number": "802-496-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAD RIVER INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "WARGO",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "802-496-2202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VT",
            "license": "042-0007289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Christine Laflamme, ATC
• Lindsay B. Jernigan, PHD, PLC
• Mad River Eye Care PLLC
• Mad River Family Health
• Mad River Health PLLC
• Mad River Integrative Medicine
• Mad River Internal Medicine
• Mad River Valley Ambulance Service, Inc.
• Mahoney Family Chiropractic, LLC
• Sean Patrick Mahoney, D.C.

• Primary Care Clinic/Center in Waitsfield, VT
• Providers in Waitsfield, VT by specialty
• Primary Care Clinic/Center in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.