Organization Active NPI

Hope Medical Clinic PLLC

  • Primary Care Clinic/Center
  • Rutland, VT
National Provider Identifier
1306116801
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
1010015655 Issued in VT
Legal business name
HOPE MEDICAL CLINIC PLLC
Practice address
92 Allen St
Rutland, VT 05701-4562
Phone
(802) 773-7502
Fax
(802) 773-7022
NPI assigned
Dec 31, 2011
Last updated
Apr 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Authorized official

Name
Mrs. Susan F Dumas, NPNPI 1477514362
Title
Owner
Phone
(802) 773-7502

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 1010015655 VT Primary

Addresses

Primary practice location

92 Allen St
Rutland, VT 05701-4562

Mailing address

92 Allen St
Rutland, VT 05701-4562
Phone (802) 773-7502

Other identifiers 5

IdentifierTypeStateIssuer
0025803OtherVTMEDICARE PTAN
5501740OtherVTMVP
1008529MedicaidVT
1020249OtherVTMEDICAID FOR HOPE MEDICAL CLINIC
47D2040632OtherCLIA WAIVER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120330000043 VT Part B Supplier - Clinic/Group Practice 4385804251 Receives reassigned benefits from 1 practitioner
Practice locations: Rutland, VT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1325289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1306116801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 ALLEN ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014562",
            "telephone_number": "802-773-7502",
            "fax_number": "802-773-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 ALLEN ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014562",
            "telephone_number": "802-773-7502",
            "fax_number": "802-773-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-31",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "DUMAS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-773-7502",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VT",
            "license": "1010015655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0025803",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "5501740",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008529",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID FOR HOPE MEDICAL CLINIC",
            "identifier": "1020249",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVER",
            "identifier": "47D2040632",
            "state": null
        }
    ],
    "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 Apr 17, 2017; 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.