Southwestern Vermont Medical Center, Inc
Organization Active NPI General Practice Physician · West Dover, VT
NPI 1134401599 · NPPES record last updated Sep 12, 2011
Key facts
- NPI
- 1134401599
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- SOUTHWESTERN VERMONT MEDICAL CENTER, INC
- Practice address
- 13 Grand Summit Way
West Dover, VT 05356 - Phone
- (802) 464-9300
- Fax
- (802) 464-9314
- NPI assigned
- Sep 12, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- SOUTHWESTERN VERMONT MEDICAL CENTER
Authorized official
- Name
- Thomas Dee
- Title
- Ceo
- Phone
- (802) 442-6361
Other NPIs on the same Medicare enrollment 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060929000045 | VT | Part B Supplier - Clinic/Group Practice | 0143138446 |
Receives reassigned benefits from 145 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Bennington, VT |
National Provider Directory
- Part of
- Southwestern Vermont
Interoperability endpoints
- https://api.platform.athenahealth.com/3744/brand/4/csg/23/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
13 Grand Summit Way
West Dover, VT 05356
Mailing address
100 Hospital Dr
Bennington, VT 05201-5004
Phone (802) 442-6361
Other names
- SVMC Mountain Medical Services
Other providers in West Dover, VT
- Sindy Lee Hassig
- Mountain Sports Medicine, Inc.
- Jason W Naylor
- Rachel Lynn Perry
- Southwestern Vermont Health Care Enterprises
- Zomar Inc
All providers in West Dover, VT · General Practice Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2011. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.