Carlos G Otis Health Care Center Inc
Organization Active NPI Rural Health Clinic/Center · Townshend, VT
NPI 1124049960 · NPPES record last updated Aug 3, 2026
Key facts
- NPI
- 1124049960
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- CARLOS G OTIS HEALTH CARE CENTER INC
- Practice address
- 185 Grafton Rd.
Townshend, VT 05353 - Phone
- (802) 365-4331
- NPI assigned
- Jul 21, 2006
- Reactivated
- Jun 6, 2020
- Organization subpart
- No
Authorized official
- Name
- Stephen Alan Brown
- Title
- Cfo
- Phone
- (802) 365-3601
Owners & managing parties with NPI records 1
-
Timothy Shafer, M.D.
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 3
Member organizations 1
Related certifications (CCN) 1
Practitioners 94
-
Kimona Alin, M.D.
-
Ewa Arnold, M.D
-
Juliette Carr, APRN
-
Meredith L Kenyon, LICSW
-
Susan Beth Kinnersley, LICSW
-
Danica GZL Lobaton Coppolo, RN, FNP-C
-
Timothy Shafer, M.D.
-
George P. Terwilliger, M.D.
-
Benjamin Warren Wright, PMHNP-BC
-
Anne Brewer, MD
-
Craig E Goldberg, DO
-
Alison B Haimes, M.D.
-
Kimberly Joyce Jordan, M.D.
-
Alan J Kopp, M.D.
-
Steven James Lengle, M.D.
-
Amanda Lindsey, CPNP-AC
-
Jason D. Mallow, M.D.
-
Kevin Michael McDonnell, M.D.
-
David Myungkee Moon, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VT
Rural health clinic certification: CCN 473981
- Legal name
- CARLOS G OTIS HEALTH CARE CENTER INC
- Doing business as
- OTIS HEALTH CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Oct 27, 1995
- Last certification
- Nov 21, 2022
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 30, 1949 in VT
- Enrollment address
- 185 Grafton Rd
Townshend, VT 05353-8820 - Related CCNs
- 471300
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Edward Druke |
Corporate Officer | Nov 1, 2018 | |
| Laure O Sweetnam |
Corporate Officer |
Jul 1, 2024 | |
| Timothy Philip Shafer |
Corporate Director | Nov 23, 2009 | 100% |
| Martha Dale |
Corporate Officer | Nov 1, 2018 | |
| Kevin Meyer |
Corporate Director |
Jan 5, 2009 | 100% |
| Thomas Kalchthaler |
Corporate Officer | Nov 1, 2018 | |
| John G. Clark |
Corporate Officer | Nov 1, 2018 | |
| Barry Emerson |
Corporate Director |
Nov 18, 2011 | 100% |
| Shelia Scheuerman |
Corporate Officer | Nov 1, 2018 | |
| Terry Pollio |
Corporate Officer | Nov 1, 2018 | |
| Stephen Alan Brown |
Corporate Director |
Dec 1, 1988 | |
| W-2 Managing Employee |
Dec 1, 1988 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040802001147 | VT | Part B Supplier - Clinic/Group Practice | 6002726387 |
Receives reassigned benefits from 89 practitioners 1 other NPI on this enrollment Practice locations: Townshend, VT |
| O20070607000603 | VT | Part a Provider - Rural Health Clinic | 6002726387 | Practice locations: Townshend, VT |
National Provider Directory
Locations
181 Corliss Ln
Colebrook, NH 03576
Phone (603) 237-8652
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
185 Grafton Rd.
Townshend, VT 05353
Mailing address
PO Box 216
Townshend, VT 05353-0216
Phone (802) 365-4331
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OVN0834 | Medicaid | VT |
Other names
- Grace Cottage Family Health
Other providers in Townshend, VT
- Alexandra Barstow
- Amy Blazej
- Jesper Brickley
- Summer Burch
- Carlos G Otis Health Care Center Inc
- Carlos G Otis Health Care Center Inc
- Carlos G. Otis Health Care Center Inc.
- Juliette Carr
- Matthew Allen Davis
- Drift Mavyn Licsw LLC
All providers in Townshend, VT · Rural Health Clinic/Center in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.