NPIMap

Organization Active NPI

Brattleboro Memorial Hospital

  • General Acute Care Hospital
  • Brattleboro, VT
National Provider Identifier
1306849708
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
648 Issued in VT
Legal business name
BRATTLEBORO MEMORIAL HOSPITAL
Doing business as
Brattleboro Memorial Hospital
Practice address
17 Belmont Ave
Brattleboro, VT 05301-3498
Phone
(802) 257-0341
Fax
(802) 257-8834
NPI assigned
May 31, 2005
Last updated
Mar 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
Reina Champney
Title
Credentialing Manager
Phone
(802) 257-8203

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Cardiovascular Disease Physician 207RC0000X
Obstetrics & Gynecology Physician 207V00000X
Orthopaedic Surgery Physician 207X00000X
Otolaryngology Physician 207Y00000X
Otolaryngic Allergy Physician 207YX0602X
Pediatrics Physician 208000000X
Surgery Physician 208600000X
Urology Physician 208800000X
General Acute Care Hospital 282N00000X 648 VT Primary
General Acute Care Hospital 282N00000X

Addresses

Primary practice location

17 Belmont Ave
Brattleboro, VT 05301-3498

Mailing address

17 Belmont Ave
Brattleboro, VT 05301-3498
Phone (802) 257-0341

Other practice location 1

1027 Western Ave
Brattleboro, VT 05301
Phone (802) 254-4545

Other identifiers 4

IdentifierTypeStateIssuer
3081119MedicaidNH
470011OtherVTBLUE CROSS PROVIDER #
0470011MedicaidVT
0005692MedicaidVT

Other names 1

  • BRATTLEBORO MEMORIAL HOSPITAL Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040812001170 VT Part A Provider - Hospital 9335112929 Practice locations: Brattleboro, VT; Putney, VT
O20040929000782 VT Part B Supplier - Clinic/Group Practice 9335112929 Receives reassigned benefits from 113 practitioners
Practice locations: Brattleboro, VT; Putney, VT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306849708. Details of each certification follow.

Hospital certification: CCN 470011

Legal name
BRATTLEBORO MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 23, 2025
Beds
104
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 26, 1904 in VT
Enrollment address
17 Belmont Ave
Brattleboro, VT 53017601
Main/Primary Hospital Location
Hospital subgroups
General

Care Compare: Hospital

Medicare Care Compare
Listed as
Brattleboro Memorial HospitalCCN 470011 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1027 Western Ave
Brattleboro, VT 05301
Phone (802) 254-4545

17 Belmont Ave
#2
Brattleboro, VT 05301
Phone (802) 251-8611

17 Belmont Ave
Bldg 2ND
Brattleboro, VT 05301
Phone (802) 275-3699

17 Belmont Ave
Ste 1
Brattleboro, VT 05301
Phone (802) 251-8611

17 Belmont Ave
Ste 1051
Brattleboro, VT 05301

17 Belmont Ave
Ste 2401
Brattleboro, VT 05301
Phone (802) 251-9965

17 Belmont Ave
Ste 3401
Brattleboro, VT 05301
Phone (802) 257-3190

17 Belmont Ave
Ste 3401B
Brattleboro, VT 05301
Phone (802) 257-2611

17 Belmont Ave
Ste 3401C
Brattleboro, VT 05301
Phone (802) 275-3699

19 Belmont Ave
#G102
Brattleboro, VT 05301
Phone (802) 251-8626

19 Belmont Ave
Ste 102
Brattleboro, VT 05301
Phone (802) 251-8626

19 Belmont Ave
Ste 1201
Brattleboro, VT 05301
Phone (802) 257-3190

19 Belmont Ave
Ste 1202
Brattleboro, VT 05301
Phone (802) 251-8650

19 Belmont Ave
Ste G105
Brattleboro, VT 05301

21 Belmont Ave
Ste 1
Brattleboro, VT 05301
Phone (802) 251-8455

21 Belmont Ave
Ste 2
Brattleboro, VT 05301
Phone (802) 251-8787

53 Fairview St
Brattleboro, VT 05301
Phone (802) 251-8455

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
David Sanville Individual Corporate OfficerInterim Cfo Oct 16, 2025
W-2 Managing EmployeeInterim Cfo Oct 16, 2025
Operational/Managerial ControlInterim Cfo Oct 16, 2025
Paul D Boutin Individual Corporate Officer Jan 1, 2022
John Meyer Individual Corporate Officer Nov 17, 2017
Elizabeth a McLarney Individual Corporate OfficerCo Ceo Nov 1, 2025
Corporate DirectorCo Ceo Nov 1, 2025
W-2 Managing EmployeeCo Ceo Nov 1, 2025
Rhonda Calhoun Individual Corporate Officer Nov 17, 2017
Tammy Richards Individual Corporate Officer Jan 1, 2022
Anne Bilodeau Individual Corporate Officer Jan 1, 2022
Chloe Learey Individual Corporate OfficerMember Jan 1, 2022
Anthony Blofson Individual Corporate OfficerCo Ceo Nov 1, 2025
Corporate DirectorCo Ceo Nov 1, 2025
W-2 Managing EmployeeCo Ceo Nov 1, 2025
Sarah Swank Individual Corporate Officer Dec 6, 2019
Carmen Derby Individual Corporate Officer Jan 1, 2022
Claudia Caine Individual Corporate DirectorDirector Mar 12, 2026
Kimberly Frost Individual Operational/Managerial ControlSr. Directory Revenue Cycle Jan 22, 2026

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 355

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 355

Affiliated clinicians 302

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 302

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1306849708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BELMONT AVE",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053013498",
            "telephone_number": "802-257-0341",
            "fax_number": "802-257-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BELMONT AVE",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053013498",
            "telephone_number": "802-257-0341",
            "fax_number": "802-257-8834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1027 Western Ave",
            "address_purpose": "LOCATION",
            "city": "Brattleboro",
            "state": "VT",
            "postal_code": "05301",
            "country_code": "US",
            "telephone_number": "802-254-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRATTLEBORO MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "CHAMPNEY",
        "authorized_official_first_name": "REINA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "802-257-8203"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0602X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "VT",
            "license": "648",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3081119",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "470011",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0470011",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005692",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRATTLEBORO MEMORIAL HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BRATTLEBORO MEMORIAL HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.