NPIMap

Organization Active NPI

Primary Care Health Partners - Vermont LLP

  • Family Medicine Physician
  • Williston, VT
National Provider Identifier
1285687616
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIMARY CARE HEALTH PARTNERS - VERMONT LLP
Practice address
600 Blair Park Rd Ste 285
Williston, VT 05495-7586
Phone
(802) 288-1140
Fax
(802) 288-1144
NPI assigned
May 18, 2006
Last updated
Jan 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Jon W Asselin
Title
Coo
Phone
(802) 872-4326

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Mental Health Counselor 101YM0800X NU
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU

Addresses

Primary practice location

600 Blair Park Rd Ste 285
Williston, VT 05495-7586

Mailing address

600 Blair Park Rd Ste 285
Williston, VT 05495-7586
Phone (802) 288-1140

Other identifiers 1

IdentifierTypeStateIssuer
OVN2198MedicaidVT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040205000572 VT Part B Supplier - Clinic/Group Practice 7810896032 Receives reassigned benefits from 51 practitioners
Practice locations: Bennington, VT; South Burlington, VT; Saint Albans, VT; S Burlington, VT; Milton, VT; Enosburg Falls, VT; Burlington, VT; Brattleboro, VT

National Provider Directory

National Provider Directory

Locations

655 Main St
Bennington, VT 05201
Phone (802) 447-2343

19 Belmont Ave
Ste 103
Brattleboro, VT 05301
Phone (802) 257-1444

1127 North Ave
Ste 1
Burlington, VT 05408
Phone (802) 846-8100

1127 North Ave
Ste 41
Burlington, VT 05408
Phone (802) 846-8100

789 Pine St
Ste 6
Burlington, VT 05401
Phone (802) 864-0693

11 Haydenberry Dr
Milton, VT 05468
Phone (802) 846-1200

11 Haydenberry Dr
Unit 103
Milton, VT 05468
Phone (802) 893-1200

51 Timber Ln
South Burlington, VT 05403
Phone (802) 864-0521

600 Blair Park Rd
Ste 190
Williston, VT 05495
Phone (802) 288-1145

600 Blair Park Rd
Ste 285
Williston, VT 05495
Phone (802) 288-1140

66 Knight Ln
Ste 10
Williston, VT 05495
Phone (802) 872-4327

Practitioners & affiliated clinicians

Practitioners 64

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 64

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1285687616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BLAIR PARK RD STE 285",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957586",
            "telephone_number": "802-288-1140",
            "fax_number": "802-288-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BLAIR PARK RD STE 285",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957586",
            "telephone_number": "802-288-1140",
            "fax_number": "802-288-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE HEALTH PARTNERS - VERMONT LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "ASSELIN",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "802-872-4326"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN2198",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.