Beverly J. Roseberry, MD, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

042-0011545 Issued in VT

Legal business name

BEVERLY J. ROSEBERRY, MD, PC

Practice address

11 Commons St
Rutland, VT 05701-4652

Phone

(802) 779-0114

Fax

(802) 779-0123

NPI assigned

Jun 11, 2008

Last updated

Oct 9, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Beverly Jean Roseberry, MD

Title

Owner

Phone

(802) 779-0114

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255046400000",
    "number": "1265692453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 COMMONS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014652",
            "telephone_number": "802-779-0114",
            "fax_number": "802-779-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 COMMONS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014652",
            "telephone_number": "802-779-0114",
            "fax_number": "802-779-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY J. ROSEBERRY, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2009-10-09",
        "status": "A",
        "authorized_official_last_name": "ROSEBERRY",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-779-0114",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042-0011545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Rutland, VT
• Providers in Rutland, VT by specialty
• Family Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.