NPIMap

Organization Active NPI

Primary Care Health Partners

  • Pediatrics Physician
  • S Burlington, VT
National Provider Identifier
1295792745
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PRIMARY CARE HEALTH PARTNERS
Practice address
51 Timber LN
S Burlington, VT 05403-5201
Phone
(802) 864-0521
Fax
(802) 864-6475
NPI assigned
Apr 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

51 Timber LN
S Burlington, VT 05403-5201

Mailing address

66 Knight LN Ste 10
Williston, VT 05495-9308
Phone (802) 872-4343

Other names 1

  • timber lane pediatrics Other name

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
47D0091274Primary Care Health Partners - Vermont, LLP51 Timber LN, South Burlington, VT 05403Certificate of waiverSep 7, 2026

National Provider Directory

National Provider Directory
Tax ID family
Primary Care Health Partners4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1295792745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 KNIGHT LN STE 10",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054959308",
            "telephone_number": "802-872-4343",
            "fax_number": "802-288-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 TIMBER LN",
            "city": "S BURLINGTON",
            "state": "VT",
            "postal_code": "054035201",
            "telephone_number": "802-864-0521",
            "fax_number": "802-864-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE HEALTH PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "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": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "timber lane pediatrics",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "timber lane pediatrics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in S Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; 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.