Individual provider Active NPI

Adrienne Rulon

  • Dentist
  • Hardwick, VT
National Provider Identifier
1184947855
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0160064345 Issued in VT
Practice address
151 North Main Street
Hardwick, VT 05843-0537
Phone
(802) 472-2260
Fax
(802) 472-2263
NPI assigned
Mar 9, 2010
Last updated
Feb 13, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0160064345 VT Primary

Addresses

Primary practice location

151 North Main Street
Hardwick, VT 05843-0537

Mailing address

165 Sherman Dr
St Johnsbury, VT 05819-9811
Phone (802) 748-9405

Other identifiers 1

IdentifierTypeStateIssuer
1017395MedicaidVT

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160601001824 VT Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6305136474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0160064345VTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Counties Health Care, Inc. Past Accepting new patients
Northern Counties Health Care, Inc. Past Accepting new patients
Northern Counties Health Care Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: adrienne.rulon.1@28542.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1184947855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SHERMAN DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199811",
            "telephone_number": "802-748-9405",
            "fax_number": "802-748-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 NORTH MAIN STREET",
            "city": "HARDWICK",
            "state": "VT",
            "postal_code": "058430537",
            "telephone_number": "802-472-2260",
            "fax_number": "802-472-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RULON",
        "first_name": "ADRIENNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "0160064345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017395",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hardwick, VT

Sources for this page

Verify at the official NPI Registry.