NPIMap

Individual provider Active NPI

Jessica C Lindert, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Bomoseen, VT
National Provider Identifier
1265769210
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
101.0083502 Issued in VT
Practice address
275 Route 30 N
Bomoseen, VT 05732-9647
Phone
(802) 468-5641
Fax
(802) 468-2923
NPI assigned
Nov 12, 2009
Last updated
Feb 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 101.0083502 VT Primary
Registered Nurse 163W00000X 026.0043536 VT

Addresses

Primary practice location

275 Route 30 N
Bomoseen, VT 05732-9647

Mailing address

275 Route 30 N
Bomoseen, VT 05732-9647
Phone (802) 468-5641

Other identifiers 1

IdentifierTypeStateIssuer
1020069MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120420000023 VT Practitioner - Nurse Practitioner 0941461818 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Counseling Service of Addison County IncGroup PAC ID 2062304439, 14 clinicians

Practice addresses (Care Compare)

89 Main St
Middlebury, VT 05753-1459
Phone (802) 388-6751

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
026.0043536VTMDRegistered Nurse
101.0083502VTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Five-Town Health Alliance, Inc CurrentSince Nov 21, 2016 Accepting new patients
Counseling Service of Addison County, Inc CurrentSince Jan 14, 2024 Accepting new patients
Five-Town Health Alliance, Inc CurrentSince Nov 21, 2016 Accepting new patients

Locations

61 Pine St
Bristol, VT 05443
Phone (802) 453-3911

61 Pine St
Bldg 4
Bristol, VT 05443
Phone (802) 453-3911

109 Catamount Park
Middlebury, VT 05753
Phone (802) 388-4021

89 Main St
Middlebury, VT 05753
Phone (802) 388-6751

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1265769210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 ROUTE 30 N",
            "city": "BOMOSEEN",
            "state": "VT",
            "postal_code": "057329647",
            "telephone_number": "802-468-5641",
            "fax_number": "802-468-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 ROUTE 30 N",
            "city": "BOMOSEEN",
            "state": "VT",
            "postal_code": "057329647",
            "telephone_number": "802-468-5641",
            "fax_number": "802-468-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDERT",
        "first_name": "JESSICA",
        "middle_name": "C",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-12",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VT",
            "license": "101.0083502",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VT",
            "license": "026.0043536",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020069",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bomoseen, VT

Sources for this page

Verify at the official NPI Registry.