NPIMap

Organization Active NPI

North Country Hospital & Health Center Inc

Doing business as North Country OB GYN Services

  • Obstetrics & Gynecology Physician
  • Newport, VT
National Provider Identifier
1295868008
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Doing business as
North Country OB GYN Services
North Country OB/GYN Services
Practice address
81 Medical Village Dr Ste 2
Newport, VT 05855-9897
Phone
(802) 334-4110
Fax
(802) 334-3281
NPI assigned
Mar 13, 2007
Last updated
Sep 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Authorized official

Name
Deborah L Brown
Title
Enrollment Specialist
Phone
(802) 334-3210

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X
Durable Medical Equipment & Medical Supplies 332B00000X
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

81 Medical Village Dr Ste 2
Newport, VT 05855-9897

Mailing address

81 Medical Village Dr
Suite 2
Newport, VT 05855-9836
Phone (802) 334-4110

Other identifiers 8

IdentifierTypeStateIssuer
0473982MedicaidVT
101315300OtherVTDEPT OF LABOR WORKERS COM
30008005MedicaidNH
OVN0584MedicaidVT
CG5262OtherVTRAILROAD MEDICARE
015608544OtherVTHARVARD PILGRAM HEALTH PL
8000747OtherVTLADIES FIRST DEPT OF HEAL
NORT00029083OtherVTBLUE SHIELD OF VERMONT

Other names 2

  • North Country OB GYN Services Doing business as
  • North Country OB/GYN Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050616000330 VT Part B Supplier - Clinic/Group Practice 9739073479 Receives reassigned benefits from 5 practitioners
Practice locations: Newport, VT
O20070720000488 VT Part A Provider - Rural Health Clinic 9739073479 Practice locations: Newport, VT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295868008. Details of each certification follow.

Rural health clinic certification: CCN 473982

Legal name
NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Doing business as
NORTH COUNTRY OB/GYN & ORTHOPAEDICS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 10, 1995
Last certification
Sep 13, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Sep 6, 1969 in VT
Enrollment address
81 Medical Village Dr
Suite 1 & 2
Newport, VT 05855-9897
Related CCNs
471304

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
North Country Anes Serv6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

186 Medical Village Dr
#1
Newport, VT 05855
Phone (802) 334-3262

189 Prouty Dr
Newport, VT 05855
Phone (802) 334-3569

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ellen Stanley Individual Corporate OfficerBoard Member-Finance Chair & Treasu Jan 1, 2024
Louise Bonvechio Individual Corporate OfficerBoard Member-Chair Jan 1, 2022
Gregory a Walker Individual Corporate OfficerBoard Member-Med Staff President Jan 1, 2022
Nancy Bullock Individual Corporate OfficerBoard Member-Secretary/Clerk Jan 1, 2022
Tracey Paul Individual Corporate OfficerCfo Jan 1, 2022 100%
Anita Flagg Individual Corporate OfficerCfo Nov 1, 2025
W-2 Managing Employee Nov 1, 2025
Steven Wright Individual Corporate DirectorBoard Member Mar 1, 2018 5%
Deborah L Brown Individual W-2 Managing EmployeeEnrollment Specialist Dec 12, 2019

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 52

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 52

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1295868008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 MEDICAL VILLAGE DR",
            "address_2": "SUITE 2",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058559836",
            "telephone_number": "802-334-4110",
            "fax_number": "802-334-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 MEDICAL VILLAGE DR STE 2",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058559897",
            "telephone_number": "802-334-4110",
            "fax_number": "802-334-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY HOSPITAL & HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "802-334-3210"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0473982",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR WORKERS COM",
            "identifier": "101315300",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30008005",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN0584",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG5262",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRAM HEALTH PL",
            "identifier": "015608544",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADIES FIRST DEPT OF HEAL",
            "identifier": "8000747",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF VERMONT",
            "identifier": "NORT00029083",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Country OB GYN Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Country OB GYN Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Country OB/GYN Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport, VT

Sources for this page

Verify at the official NPI Registry.