Our Lady of Providence VT. Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

0198 Issued in VT

Legal business name

OUR LADY OF PROVIDENCE VT. INC.

Practice address

47 W Spring St
Winooski, VT 05404-1319

Phone

(802) 655-2395

NPI assigned

Feb 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carmen Proulx

Title

Sister

Phone

(802) 655-2395

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• OurLady of Providence Former legal business name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285769174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 W SPRING ST",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054041319",
            "telephone_number": "802-655-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 W SPRING ST",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054041319",
            "telephone_number": "802-655-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF PROVIDENCE VT. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PROULX",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "SISTER",
        "authorized_official_telephone_number": "802-655-2395"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "VT",
            "license": "0198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047W267",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047W152",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OurLady of Providence",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Assisted Living Facility in Winooski, VT
• Providers in Winooski, VT by specialty
• Assisted Living Facility in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.