NPIMap

Organization Active NPI

Northeastern Vermont Regional Hospital, Inc

  • Critical Access Hospital
  • St Johnsbury, VT
National Provider Identifier
1275576704
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
673 Issued in VT
Legal business name
NORTHEASTERN VERMONT REGIONAL HOSPITAL, INC
Practice address
1315 Hospital Dr
St Johnsbury, VT 05819-9210
Phone
(802) 748-8141
Fax
(802) 748-4098
NPI assigned
Jun 13, 2006
Last updated
Feb 11, 2020By the provider in NPPES
Organization subpart
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

Authorized official

Name
Robert N Hersey
Title
Cfo
Phone
(802) 748-7520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 673 VT Primary

Addresses

Primary practice location

1315 Hospital Dr
St Johnsbury, VT 05819-9210

Mailing address

1315 Hospital Dr
PO Box 905
St Johnsbury, VT 05819-9210
Phone (802) 748-8141

Other identifiers 2

IdentifierTypeStateIssuer
0471303MedicaidVT
99470023MedicaidNH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061104000315 VT Part A Provider - Critical Access Hospital 3678481405 Receives reassigned benefits from 61 practitioners
2 other NPIs on this enrollment
Practice locations: St Johnsbury, VT; Lyndonville, VT; Saint Johnsbury, VT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275576704. Details of each certification follow.

Hospital certification: CCN 471303

Legal name
NORTHEASTERN VERMONT REGIONAL HOSPITAL INC
Doing business as
NVRH
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 1, 2004
Last certification
May 17, 2023
Beds
75
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
1315 Hospital Dr
Saint Johnsbury, VT 58199210
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 14

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

View all 14

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Northeastern Vermont Regional HospitalCCN 471303 · All quality measures
Overall star rating
3 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Sara J Simpson Individual Corporate DirectorSecretary of the Board Dec 1, 2020
Shawn Patrick Tester Individual Corporate OfficerCeo Nov 26, 2018
Thaddeus R Richardson Individual Corporate DirectorTrustee Dec 1, 2019
Susan L Carr Individual Corporate DirectorPresident of the Auxiliary Dec 1, 2023
Joseph S Kasprzak Individual Corporate DirectorTreasurer of the Board/Trustee Dec 1, 2016
Daniel D Daley Individual Corporate DirectorTrustee Dec 1, 2023
Cynthia S Stuart Individual Corporate DirectorTrustee Dec 1, 2023
Steve Arthur Feltus Individual Corporate DirectorTrustee Dec 1, 2016
Steven McConnell Individual Corporate DirectorTrustee Dec 1, 2017
Jennifer K Harris Individual Corporate DirectorTrustee Dec 1, 2024
Warren C Dow Individual Corporate DirectorVice Chair of the Board/Trustee Dec 1, 2020
Roena D Whitehill Individual Corporate DirectorTrustee Dec 1, 2024
Henry S Parker Individual Corporate DirectorTrustee Dec 1, 2023
Mark S Bowen Individual Corporate DirectorTrustee Dec 1, 2021
Natalie B Morris Individual Corporate DirectorTrustee Dec 1, 2022
Robert J Grant Individual Corporate DirectorVice President of the Medical Staff Jan 1, 2025
Peter F Crosby Individual Corporate DirectorTrustee Dec 1, 2021
Deborah a Harrigan Individual Corporate DirectorPresident of the Medical Staff Jan 1, 2025
John S Kascenska Individual Corporate DirectorChair of the Board/Trustee Dec 1, 2019
Kinsley Sicard Individual Corporate DirectorTrustee Sep 1, 2023
Andre Bissonnette Individual Corporate OfficerChief Financial Officer Jul 15, 2022
W-2 Managing EmployeeChief Financial Officer Jul 15, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 75

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 75

Affiliated clinicians 277

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 277

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1275576704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 HOSPITAL DR",
            "address_2": "PO BOX 905",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199210",
            "telephone_number": "802-748-8141",
            "fax_number": "802-748-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 HOSPITAL DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199210",
            "telephone_number": "802-748-8141",
            "fax_number": "802-748-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN VERMONT REGIONAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "HERSEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "802-748-7520"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "VT",
            "license": "673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0471303",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99470023",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johnsbury, VT

Sources for this page

Verify at the official NPI Registry.