Individual provider Active NPI

Suzanne Redden, MD

  • General Practice Physician
  • Rutland, VT
National Provider Identifier
1164439378
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0420010566 Issued in VT
Practice address
160 Allen St
Rutland, VT 05701-4560
Phone
(802) 775-7111
Fax
(802) 747-6260
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0420010566 VT Primary

Addresses

Primary practice location

160 Allen St
Rutland, VT 05701-4560

Mailing address

160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040427000667 VT Practitioner - Internal Medicine 9032106661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rutland Hospital, Inc.Group PAC ID 7214846377, 186 clinicians

Practice addresses (Care Compare)

160 Allen St
Rutland, VT 05701-4560
Phone (802) 775-7111

Hospital & facility affiliations

  • Rutland Regional Medical Center Hospital, Rutland, VT, CCN 470005
  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0420010566VTMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutland Hospital, Inc. CurrentSince Apr 3, 2003 Accepting new patients
Rutland Hospital, Inc. CurrentSince Apr 3, 2003 Accepting new patients
Rutland Hospital, Inc Current Accepting new patients
Rutland Hospital, Inc. Current Accepting new patients
Mid Vermont Pathology PC Current Accepting new patients
Rutland Hospital, Inc. Current Accepting new patients
Rutland Hospital, Inc. Past Accepting new patients

Locations

160 Allen St
Rutland, VT 05701

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/6f43d0e7-6ff2-489b-abdc-44e8a5e0ca0a/

Organizations & group practices 7

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 3

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164439378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 ALLEN ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014560",
            "telephone_number": "802-775-7111",
            "fax_number": "802-747-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ALLEN ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014560",
            "telephone_number": "802-775-7111",
            "fax_number": "802-747-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDEN",
        "first_name": "SUZANNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VT",
            "license": "0420010566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.