Individual provider Active NPI

Amy Maxine Tree, MACP

  • Psychologist
  • Burlington, VT
National Provider Identifier
1215092242
Registry record updated Jan 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
0470000679 Issued in VT
Practice address
3 Main St
Suite 216
Burlington, VT 05401-5216
Phone
(802) 651-7517
Fax
(802) 860-1234
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0470000679 VT Primary

Addresses

Primary practice location

3 Main St
Suite 216
Burlington, VT 05401-5216

Mailing address

3 Main St
Suite 216
Burlington, VT 05401-5216
Phone (802) 651-7517

Other identifiers 6

IdentifierTypeStateIssuer
1007293MedicaidVT
2076328OtherVTCIGNA
39584OtherVTBCBS
191313000OtherMAGELLAN BEHAVIORAL HEALT
559398OtherVALUE OPTIONS
300215965OtherUNITED BEHAVIORAL HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0470000679VTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kathryn Fallin, M.S. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233360000000",
    "number": "1215092242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MAIN ST",
            "address_2": "SUITE 216",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015216",
            "telephone_number": "802-651-7517",
            "fax_number": "802-860-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MAIN ST",
            "address_2": "SUITE 216",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015216",
            "telephone_number": "802-651-7517",
            "fax_number": "802-860-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREE",
        "first_name": "AMY",
        "middle_name": "MAXINE",
        "credential": "MACP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2009-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VT",
            "license": "0470000679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007293",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2076328",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "39584",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALT",
            "identifier": "191313000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "559398",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "300215965",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2009; 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.