Individual provider Active NPI

Gerald Scott Waterman, M.D.

  • Child & Adolescent Psychiatry Physician
  • Burlington, VT
National Provider Identifier
1154423507
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
042-0008732 Issued in VT
Practice address
1 S Prospect St
Arnold 6
Burlington, VT 05401-3456
Phone
(802) 847-4560
Fax
(802) 847-8747
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 042-0008732 VT
Child & Adolescent Psychiatry Physician 2084P0804X 042-0008732 VT Primary

Addresses

Primary practice location

1 S Prospect St
Arnold 6
Burlington, VT 05401-3456

Mailing address

PO Box 479
Charlotte, VT 05445-0479
Phone (802) 425-4482

Other identifiers 2

IdentifierTypeStateIssuer
01469070MedicaidNY
1004305MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0008732VTMDChild & Adolescent Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1154423507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 479",
            "city": "CHARLOTTE",
            "state": "VT",
            "postal_code": "054450479",
            "telephone_number": "802-425-4482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S PROSPECT ST",
            "address_2": "ARNOLD 6",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013456",
            "telephone_number": "802-847-4560",
            "fax_number": "802-847-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "GERALD",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042-0008732",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VT",
            "license": "042-0008732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01469070",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004305",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.