Individual provider Active NPI

Marietta C Scholten, MD

  • Family Medicine Physician
  • Saint Albans, VT
National Provider Identifier
1114962495
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0420007852 Issued in VT
Practice address
148 Fairfield St
Saint Albans, VT 05478-1729
Phone
(802) 524-2168
Fax
(802) 524-0411
NPI assigned
Jun 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0420007852 VT Primary

Addresses

Primary practice location

148 Fairfield St
Saint Albans, VT 05478-1729

Mailing address

PO Box 166
148 Fairfield Street
Saint Albans, VT 05478-0166
Phone (802) 524-2168

Other identifiers 1

IdentifierTypeStateIssuer
0009209MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110118000283 VT Practitioner - Family Practice 3577752971 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0420007852VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Family Medicine CurrentSince May 1, 2013 Accepting new patients

Locations

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114962495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 166",
            "address_2": "148 FAIRFIELD STREET",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054780166",
            "telephone_number": "802-524-2168",
            "fax_number": "802-524-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 FAIRFIELD ST",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054781729",
            "telephone_number": "802-524-2168",
            "fax_number": "802-524-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOLTEN",
        "first_name": "MARIETTA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "0420007852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009209",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, VT

Sources for this page

Verify at the official NPI Registry.