Active NPI
Mary M Beerworth, M.D.
- Obstetrics & Gynecology Physician
- Rutland, VT
National Provider Identifier
1306843537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 42-0007267
- Practice address
- 147 Allen Street
Rutland, VT 05701-4570 - Phone
- (802) 775-1901
- Fax
- (802) 773-2867
- NPI assigned
- Jul 1, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 42-0007267 | VT | Primary |
Addresses
Primary practice location
147 Allen Street
Rutland, VT 05701-4570
Mailing address
147 Allen St
Rutland, VT 05701-4570
Phone (802) 775-1901
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 216-5217 | Other | VT | BC/BS GROUP PROVIDER # |
| 16223 | Other | VT | MVP ID # |
| 10002440 | Other | VT | CDPHP ID # |
| VT9065 | Medicaid | VT | |
| 216-5411 | Other | VT | BC/BS INDIVIDUAL # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42-0007267 | VT | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328486400000",
"number": "1306843537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 ALLEN ST",
"city": "RUTLAND",
"state": "VT",
"postal_code": "057014570",
"telephone_number": "802-775-1901",
"fax_number": "802-773-2867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 ALLEN STREET",
"city": "RUTLAND",
"state": "VT",
"postal_code": "057014570",
"telephone_number": "802-775-1901",
"fax_number": "802-773-2867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEERWORTH",
"first_name": "MARY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-01",
"last_updated": "2012-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "VT",
"license": "42-0007267",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS GROUP PROVIDER #",
"identifier": "216-5217",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP ID #",
"identifier": "16223",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP ID #",
"identifier": "10002440",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "VT9065",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS INDIVIDUAL #",
"identifier": "216-5411",
"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 Feb 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.