Individual provider Active NPI

Sally J Beayon, FNP-C

  • Family Medicine Physician
  • Bomoseen, VT
National Provider Identifier
1124672340
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
101.0134375 Issued in VT
Practice address
275 Route 30 N
Bomoseen, VT 05732-9647
Phone
(802) 468-5641
NPI assigned
Jul 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Nurse Practitioner 363LX0106X 101.0134375 VT
Family Medicine Physician 207Q00000X 101.0134375 VT Primary

Addresses

Primary practice location

275 Route 30 N
Bomoseen, VT 05732-9647

Mailing address

97 Freeman HL
Pittsford, VT 05763-9575
Phone (802) 483-0031

Other practice location 1

278 Vt Route 149
West Pawlet, VT 05775-9798
Phone (802) 645-0580

Other practice location 2

1 General Wing Rd
Rutland, VT 05701-4681
Phone (802) 773-1551

Other practice location 3

420 Grove St
Brandon, VT 05733-9062
Phone (802) 247-6305

Other practice location 4

71 Allen St Ste 403
Rutland, VT 05701-4570
Phone (802) 772-7992

Other practice location 5

2987 Vt Route 22A
Shoreham, VT 05770-9728
Phone (802) 897-7000

Other practice location 6

215 Stratton Rd
Rutland, VT 05701-4621
Phone (802) 773-3386

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191003002431 VT Practitioner - Nurse Practitioner 3870824998 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Rutland Region, Inc. Family Medicine CurrentSince Apr 1, 2020 Accepting new patients
Community Health Centers of the Rutland Region, Inc. Family Medicine CurrentSince Apr 1, 2020 Accepting new patients
Marble Valley Healthworks, LLC Family Medicine CurrentSince Aug 4, 2019 Accepting new patients
Community Health Centers of the Rutland Region, Inc. Family Medicine CurrentSince Apr 1, 2020 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Community Health Centers of the Rutland Region, Inc. Family Medicine CurrentSince Apr 1, 2020 Accepting new patients
Community Health Centers of the Rutland Region Inc Family Medicine CurrentSince Apr 1, 2020 Accepting new patients
Community Health Centers of the Rutland Region Inc Family Medicine Current Accepting new patients

Locations

275 VT 30 N
Bomoseen, VT 05732
Phone (802) 468-5641

420 Grove St
Brandon, VT 05733
Phone (802) 247-6305

1 General Wing Rd
Rutland, VT 05701
Phone (802) 773-9131

215 Stratton Rd
Rutland, VT 05701
Phone (802) 773-3386

71 Allen St
Ste 403
Rutland, VT 05701
Phone (802) 772-4414

8 Commons St
Rutland, VT 05701
Phone (802) 770-1805

71 Allen St
Ste 402
Rutland, VT 05701
Phone (800) 468-9118

2987 Vt Route 22A
Shoreham, VT 05770
Phone (802) 897-7000

278 Vt Route 149
West Pawlet, VT 05775
Phone (800) 468-9118

Interoperability endpoints

  • Direct secure messaging: sbeayon@chcrr.medentdirect.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/zA015PZlU6y4mS2M66rhwFskWFFyp2EA/

Organizations & group practices 10

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers of the Rutland Region Inc 103 clinicians

Practice addresses (Care Compare)

215 Stratton Rd
Rutland, VT 05701-4621
Phone (802) 773-3386

275 Route 30 N
Bomoseen, VT 05732-9647
Phone (802) 468-5641

Hospital & facility affiliations

  • Vna & Hospice of the Southwest Region, Inc. Home health agency, Rutland, VT, CCN 477007
  • Bayada Home Health Care, Inc. Home health agency, Rutland, VT, CCN 477019
  • Rutland Regional Medical Center Hospital, Rutland, VT, CCN 470005

NPI Registry JSON

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1124672340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 FREEMAN HL",
            "city": "PITTSFORD",
            "state": "VT",
            "postal_code": "057639575",
            "telephone_number": "802-483-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 ROUTE 30 N",
            "city": "BOMOSEEN",
            "state": "VT",
            "postal_code": "057329647",
            "telephone_number": "802-468-5641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "278 Vt Route 149",
            "address_purpose": "LOCATION",
            "city": "West Pawlet",
            "state": "VT",
            "postal_code": "057759798",
            "country_code": "US",
            "telephone_number": "802-645-0580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 General Wing Rd",
            "address_purpose": "LOCATION",
            "city": "Rutland",
            "state": "VT",
            "postal_code": "057014681",
            "country_code": "US",
            "telephone_number": "802-773-1551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "420 Grove St",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "VT",
            "postal_code": "057339062",
            "country_code": "US",
            "telephone_number": "802-247-6305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "71 Allen St Ste 403",
            "address_purpose": "LOCATION",
            "city": "Rutland",
            "state": "VT",
            "postal_code": "057014570",
            "country_code": "US",
            "telephone_number": "802-772-7992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2987 Vt Route 22A",
            "address_purpose": "LOCATION",
            "city": "Shoreham",
            "state": "VT",
            "postal_code": "057709728",
            "country_code": "US",
            "telephone_number": "802-897-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 Stratton Rd",
            "address_purpose": "LOCATION",
            "city": "Rutland",
            "state": "VT",
            "postal_code": "057014621",
            "country_code": "US",
            "telephone_number": "802-773-3386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEAYON",
        "first_name": "SALLY",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "VT",
            "license": "101.0134375",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "101.0134375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bomoseen, VT

Sources for this page

Verify at the official NPI Registry.