NPIMap

Organization Active NPI

Northern Counties Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Danville, VT
National Provider Identifier
1255458501
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTHERN COUNTIES HEALTH CARE, INC.
Practice address
26 Cedar Lane
Danville, VT 05819
Phone
(802) 684-2275
Fax
(802) 684-3839
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Authorized official

Name
Patrick Flood
Title
Executive Director/Ceo
Phone
(802) 748-9405

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Health Service Clinic/Center 261QH0100X
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

26 Cedar Lane
Danville, VT 05819

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
0473803MedicaidVT
471802OtherVTMEDICARE PROVIDER NUMBER

Other names 1

  • Danville Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100827000422 VT Part A Provider - Federally Qualified Health Center (FQHC) 2860300936 Practice locations: Danville, VT

Federally qualified health center certification: CCN 471802

Legal name
NORTHERN COUNTIES HEALTH CARE INC
Doing business as
DANVILLE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Sep 19, 1976 in VT
Enrollment address
26 Cedar LN
Danville, VT 58289751

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
Hardwick Area HLTH Cent17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Pamela Smart Individual Corporate Director Oct 28, 2020
Angela Neil Individual Corporate OfficerCfo Feb 1, 2021
Patricia Aubin Individual Corporate Director Oct 27, 2021
Michael K Costa Individual Corporate OfficerCeo Apr 1, 2019
W-2 Managing EmployeeCeo Apr 1, 2019
Stacey Tanner Individual W-2 Managing Employee Aug 24, 2020
Adrianne Hutchin Individual Corporate Director Oct 27, 2021
Justin Barton-Caplin Individual Corporate Director Oct 28, 2020
Steven Winkler Individual Corporate Director Oct 27, 2021
Sarah Rebecca Galloway Individual Corporate Director Oct 28, 2020
Maryellen Griffin Individual Corporate Director Oct 28, 2020
Louisa Driscoll Individual Corporate Director Oct 28, 2020
Sophia Boyle Hall Individual Corporate Director Oct 28, 2020

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391040000000",
    "number": "1255458501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 SHERMAN DRIVE",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "05819",
            "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": "26 CEDAR LANE",
            "city": "DANVILLE",
            "state": "VT",
            "postal_code": "05819",
            "telephone_number": "802-684-2275",
            "fax_number": "802-684-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN COUNTIES HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2014-01-30",
        "status": "A",
        "authorized_official_last_name": "FLOOD",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CEO",
        "authorized_official_telephone_number": "802-748-9405"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0473803",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "471802",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Danville Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danville, VT

Sources for this page

Verify at the official NPI Registry.