Mad River Integrative Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MAD RIVER INTEGRATIVE MEDICINE

Practice address

5360 Main St
Suite 2
Waitsfield, VT 05673-6003

Phone

(802) 496-2202

NPI assigned

May 24, 2007

Last updated

Oct 27, 2007By 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

Tim Wargo

Title

Owner

Phone

(802) 496-2202

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193443200000",
    "number": "1124239199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5360 MAIN ST",
            "address_2": "SUITE 2",
            "city": "WAITSFIELD",
            "state": "VT",
            "postal_code": "056736003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5360 MAIN ST",
            "address_2": "SUITE 2",
            "city": "WAITSFIELD",
            "state": "VT",
            "postal_code": "056736003",
            "telephone_number": "802-496-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAD RIVER INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2007-10-27",
        "status": "A",
        "authorized_official_last_name": "WARGO",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-496-2202"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 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.
• Morgan McClintic, OD

• Family Medicine Physician in Waitsfield, VT
• Providers in Waitsfield, VT by specialty
• Family Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2007; 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.