Individual provider Active NPI

Miller Bowen Pearsall, M.D.

  • Emergency Medicine Physician
  • Saint Albans, VT
National Provider Identifier
1174786826
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
042.0012979 Issued in VT
Practice address
133 Fairfield St
Saint Albans, VT 05478-1726
Phone
(802) 524-5911
NPI assigned
Jul 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 042.0012979 VT Primary

Addresses

Primary practice location

133 Fairfield St
Saint Albans, VT 05478-1726

Mailing address

55 Spruce St
Burlington, VT 05401-4548
Phone (802) 233-1298

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
I20141021002322 VT Practitioner - Emergency Medicine 5698930550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Center IncGroup PAC ID 5496714313, shared by 4 NPIs, 105 clinicians

Practice addresses (Care Compare)

133 Fairfield St
Saint Albans, VT 05478-1726
Phone (802) 524-5911

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042.0012979VTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center, Inc. Current Accepting new patients
Northwestern Medical Center, Inc. CurrentSince Oct 1, 2014 Accepting new patients
Northwestern Medical Center, Inc CurrentSince Oct 1, 2014 Accepting new patients
Northwestern Medical Center Inc CurrentSince Apr 9, 2018 Accepting new patients

Locations

927 Ethan Allen Hwy
Unit 2
Milton, VT 05468
Phone (802) 524-8911

133 Fairfield St
Ste 101
Saint Albans, VT 05478
Phone (802) 524-1232

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

260 Crest Rd
Ste 101
Saint Albans, VT 05478
Phone (802) 524-1223

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

260 Crest Rd
Ste 103
Saint Albans, VT 05478
Phone (802) 524-8911

Organizations & group practices 4

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 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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1174786826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SPRUCE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014548",
            "telephone_number": "802-233-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 FAIRFIELD ST",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054781726",
            "telephone_number": "802-524-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSALL",
        "first_name": "MILLER",
        "middle_name": "BOWEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "042.0012979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, VT

Sources for this page

Verify at the official NPI Registry.