Green Mountain Family Practice

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

GREEN MOUNTAIN FAMILY PRACTICE

Practice address

63 Crescent Ave
Northfield, VT 05663-5704

Phone

(802) 485-4161

Fax

(802) 485-4163

NPI assigned

Dec 16, 2005

Organization subpart

No

Name

Craig Demming Sullivan

Title

Partner

Phone

(802) 485-4161

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ana Burtnett, PA-C

  • Physician Assistant
  • Northfield, VT
  • NPI 1316985831
  NPD (past)
• Sarah Lynn Davies, M.D.

  • Family Medicine Physician
  • Northfield, VT
  • NPI 1770601544
  NPD (past)
• Debra Maloney-Evans, NP

  • Family Nurse Practitioner
  • Northfield, VT
  • NPI 1770596991
  NPD (past)
• Deborah M O Hara, PA C

  • Physician Assistant
  • Northfield, VT
  • NPI 1932182292
  NPD (past)
• Elisa Brettler Vandervort, FNP, CNM

  • Advanced Practice Midwife
  • Burlington, VT
  • NPI 1598741019
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194701623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 CRESCENT AVE",
            "city": "NORTHFIELD",
            "state": "VT",
            "postal_code": "056635704",
            "telephone_number": "802-485-4161",
            "fax_number": "802-485-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 CRESCENT AVE",
            "city": "NORTHFIELD",
            "state": "VT",
            "postal_code": "056635704",
            "telephone_number": "802-485-4161",
            "fax_number": "802-485-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN MOUNTAIN FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "DEMMING",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "802-485-4161"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005666",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsea Faure, MS
• Kerri N Fredette, COTA
• Carolyn Simmons Gaeckle, PMHNP
• Anissa Louise Garnsey
• Alanna Girardin
• Ella Anne Griffin
• Tara Anne Grogan
• Megan Hale, LPN
• Addison Anne Hall, AEMT
• Christopher E. Henderson

• All providers in Northfield, VT
• Primary Care Clinic/Center in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.