David Gundersen, MSW
Individual provider Active NPI Social Worker · Rutland, VT
NPI 1235905415 · NPPES record last updated Oct 10, 2024
Key facts
- NPI
- 1235905415
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 78 S Main St
Rutland, VT 05701-4594 - Phone
- (802) 417-9048
- NPI assigned
- Nov 29, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1046 Temple Rd
Benson, VT 05743-2102
78 S Main St
Rutland, VT 05701-4591
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Social Worker | 104100000X | NY | Yes |
Addresses
Primary practice location
78 S Main St
Rutland, VT 05701-4594
Mailing address
PO Box 222
Rutland, VT 05702-0222
Other providers in Rutland, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.