NPIMap

Organization Active NPI

Central Vermont Medical Center Inc

Doing business as Woodridge Nursing Home

  • Skilled Nursing Facility
  • Berlin, VT
National Provider Identifier
1215023759
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
270000165 Issued in VT
Legal business name
CENTRAL VERMONT MEDICAL CENTER INC
Doing business as
Woodridge Nursing Home
Practice address
142 Woodridge Dr.
Berlin, VT 05602-9165
Phone
(802) 371-4700
Fax
(802) 371-4720
NPI assigned
Oct 4, 2006
Last updated
Feb 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Authorized official

Name
Cheyenne Holland
Title
Cfo
Phone
(802) 371-4109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 270000165 VT Primary

Addresses

Primary practice location

142 Woodridge Dr.
Berlin, VT 05602-9165

Mailing address

PO Box 550
Barre, VT 05641-0550
Phone (802) 371-4700

Other identifiers 3

IdentifierTypeStateIssuer
0007208OtherVTMEDICAID PHARMACY
5624220002OtherDMERC
0475045MedicaidVT

Other names 1

  • Woodridge Nursing Home Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050722000343 VT Part A Provider - Skilled Nursing Facility 9335138817 Practice locations: Berlin, VT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215023759. Details of each certification follow.

Skilled nursing facility certification: CCN 475045

Legal name
CENTRAL VERMONT MEDICAL CENTER INC
Doing business as
WOODRIDGE REHABILITATION AND NURSING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 28, 1993
Last certification
Nov 6, 2024
Beds
153
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1984 in VT
Enrollment address
142 Woodridge Rd
Berlin, VT 05602-9165
Nursing home name
WOODRIDGE NURSING HOME
Affiliated entity
UNIVERSITY OF VERMONT HEALTH NETWORK

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Woodridge Nursing HomeCCN 475045 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Oct 28, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
153140.6 residents per day on average
Chain
University of Vermont Health Network3 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
2Fines totaling $21,453

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
47D0660975Woodridge Rehabilitation & Nursing142 Woodridge Rd, Berlin, VT 05602Certificate of waiverJul 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Central Vermont Hospita2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michael Dellipriscoli Individual Corporate Director Jan 1, 2024
Trustee of the SNF Jan 1, 2024
Timothy Whitman Individual Corporate Director Mar 5, 2025
Operational/Managerial Control Mar 5, 2025
Adp of the SNF Jun 3, 2025
Lisa Muller Individual Corporate Director Dec 1, 2021
Trustee of the SNF Dec 1, 2021
Katherine Costello Individual Corporate Director Apr 28, 2025
Operational/Managerial Control Apr 28, 2025
Adp of the SNF Jun 26, 2025
Constance Colman Individual Corporate Director Apr 28, 2018
Trustee of the SNF Apr 28, 2018
Kristin Carlson Individual Corporate Director Jan 1, 2025
Trustee of the SNF Jan 1, 2025
Kimberly Patnaude Individual Corporate OfficerChief Financial Officer Mar 15, 2021
Operational/Managerial Control Mar 15, 2021
Joyce Judy Individual Corporate Director Dec 12, 2013
Trustee of the SNF Dec 12, 2013
The University of Vermont Health Network Inc. Organization, Burlington, VT Non-profit 5% Or Greater Direct Ownership Interest Nov 17, 2014 100%
Sunil Eappen Individual Corporate Director Nov 28, 2022
Trustee of the SNF Nov 28, 2022
Erica Metzger Hare Individual Corporate Director Jan 3, 2023
Trustee of the SNF Jan 3, 2023
Ryan D Clouser Individual Corporate DirectorChief Medical Officer Jan 1, 2024
Trustee of the SNF Jan 1, 2024
Anna T Noonan Individual Corporate OfficerVice President and Coo Jul 24, 2017
Operational/Managerial Control Jul 24, 2017
Trustee of the SNF Jul 24, 2017
Christine Werneke Individual Corporate OfficerSVP, President HHH & Post Acute Nov 19, 2024
Operational/Managerial Control Nov 19, 2024
Joan Marie Misek Individual Corporate Director Dec 1, 2019
Trustee of the SNF Dec 1, 2019
Benjamin G Smith Individual Corporate Director Mar 26, 2025
Trustee of the SNF Mar 26, 2025

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708041600000",
    "number": "1215023759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410550",
            "telephone_number": "802-371-4700",
            "fax_number": "802-371-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 WOODRIDGE DR.",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029165",
            "telephone_number": "802-371-4700",
            "fax_number": "802-371-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL VERMONT MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "CHEYENNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "802-371-4109"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VT",
            "license": "270000165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PHARMACY",
            "identifier": "0007208",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5624220002",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0475045",
            "state": "VT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "esmd.cioxhealth.com and OID is '2.16.840.1.113883.3.6635.1.1'",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Woodridge Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berlin, VT

Sources for this page

Verify at the official NPI Registry.