Clarence Sherman Ivie III, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

032-0000512 Issued in VT

Practice address

111 Colchester Ave
WP-2
Burlington, VT 05401-1473

Phone

(802) 847-2415

Fax

(802) 847-2965

NPI assigned

May 16, 2006

Last updated

May 23, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Anesthesiology Associates of Bennington

  • Anesthesiology Physician
  • Bennington, VT
  • NPI 1689628786
  NPD (past)
• Hilton Head Anesthesia, PA

  • Pain Medicine (Anesthesiology) Physician
  • Hilton Head Island, SC
  • NPI 1104879626
  NPD (past)
• Palmetto Anesthesia and Pain, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Hilton Head Island, SC
  • NPI 1891748356
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369267200000",
    "number": "1275585689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-2415",
            "fax_number": "802-847-2965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "WP-2",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-2415",
            "fax_number": "802-847-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVIE",
        "first_name": "CLARENCE",
        "middle_name": "SHERMAN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2013-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VT",
            "license": "032-0000512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "VN417801",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013468",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Irvine
• Brian Hilbert Irwin, M.D.
• Elizabeth Isaacoff, MD
• Frank Paul Ittleman, MD
• Masha Y Ivanova, PHD
• Laura Biron Ivins, LICSW, AAP
• Anita Subramanian Iyer, M.D.
• Liliana Izzo
• J Allen Puma OD PC (Advanced Vision Care and Contact Lens Center)
• Jab Inc

• Anesthesiology Physician in Burlington, VT
• Providers in Burlington, VT by specialty
• Anesthesiology Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.