Individual provider Active NPI

Laurie M Davignon, CPNP

  • Nurse Practitioner
  • South Burlington, VT
National Provider Identifier
1134343239
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
101-0134749 Issued in VT
Practice address
62 Tilley Dr Ste 202
South Burlington, VT 05403-4407
Phone
(802) 847-4576
NPI assigned
Apr 12, 2007
Last updated
May 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 233795 MA
Nurse Practitioner 363L00000X 101-0134749 VT Primary

Addresses

Primary practice location

62 Tilley Dr Ste 202
South Burlington, VT 05403-4407

Mailing address

535 Faunce Corner Rd
Dartmouth, MA 02747-1242
Phone (508) 996-3991

Other practice location 1

35 Pearl St
Suite 300
Brockton, MA 02301-2866
Phone (508) 584-6300

Other practice location 2

535 Faunce Corner Rd
Dartmouth, MA 02747-1242
Phone (508) 996-3991

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
I20210520002492 VT Practitioner - Nurse Practitioner 7214017524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

62 Tilley Dr
Suite 201
South Burlington, VT 05403-4407
Phone (802) 847-3737

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233795MAMDNurse Practitioner
101-0134749VTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc CurrentSince May 1, 2021 Accepting new patients
Hawthorn Medical Associates, LLC Nurse Practitioner Past Accepting new patients
Fletcher Allen Health Care Inc Past Accepting new patients

Locations

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

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

62 Tilley Dr
Ste 201
South Burlington, VT 05403
Phone (802) 847-3737

62 Tilley Dr
Ste 202
South Burlington, VT 05403
Phone (802) 847-4576

Interoperability endpoints

  • Direct secure messaging: ldavignon418833@direct.uvmhealth.org

Organizations & group practices 3

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1134343239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 FAUNCE CORNER RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471242",
            "telephone_number": "508-996-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 TILLEY DR STE 202",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054034407",
            "telephone_number": "802-847-4576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Pearl St",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023012866",
            "country_code": "US",
            "telephone_number": "508-584-6300",
            "fax_number": "508-580-4664",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "535 Faunce Corner Rd",
            "address_purpose": "LOCATION",
            "city": "Dartmouth",
            "state": "MA",
            "postal_code": "027471242",
            "country_code": "US",
            "telephone_number": "508-996-3991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIGNON",
        "first_name": "LAURIE",
        "middle_name": "M",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "233795",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VT",
            "license": "101-0134749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.