Active NPI
Regina Denise Trailweaver, LICSW
- Clinical Social Worker
- Rutland, VT
National Provider Identifier
1285708644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 089-0000723
- Practice address
- 128 Merchants Row RM 605
Rutland, VT 05701-5909 - Phone
- (802) 773-1411
- NPI assigned
- Nov 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089-0000723 | VT | Primary |
Addresses
Primary practice location
128 Merchants Row RM 605
Rutland, VT 05701-5909
Mailing address
342 VT Route 100
Hancock, VT 05748
Phone (802) 767-9263
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007305 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070103000408 | VT | Practitioner - Clinical Social Worker | 9335149061 | Practice locations: Barre, VT |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
65 Elm St
Suite 6
Barre, VT 05641-3545
Phone (802) 371-9648
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 089-0000723 | VT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1285708644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "342 VT ROUTE 100",
"city": "HANCOCK",
"state": "VT",
"postal_code": "05748",
"telephone_number": "802-767-9263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 MERCHANTS ROW RM 605",
"city": "RUTLAND",
"state": "VT",
"postal_code": "057015909",
"telephone_number": "802-773-1411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAILWEAVER",
"first_name": "REGINA",
"middle_name": "DENISE",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VT",
"license": "089-0000723",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007305",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rutland, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.