Little Rivers Health Care, Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089-0091985 Issued in VT

Legal business name

LITTLE RIVERS HEALTH CARE, INC.

Practice address

2420 Route 302
Wells River, VT 05081-9750

Phone

(802) 757-2711

NPI assigned

Mar 15, 2018

Last updated

May 24, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

LITTLE RIVERS HEALTH CARE, INC.As reported in NPPES

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

Authorized official

Name

Andrew Barter

Title

Ceo

Phone

(802) 222-4637

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316440456. Details of each certification follow.

• CCN 471867 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 471867

Legal name

LITTLE RIVERS HEALTH CARE INC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 30, 2018

Last certification

Apr 30, 2018

Ownership / control type

For profit – corporation

Facility address

2420 Route 302
Wells River, VT 05081

Part of

Little Rivers Health Care I

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1316440456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8",
            "city": "NEWBURY",
            "state": "VT",
            "postal_code": "050510008",
            "telephone_number": "802-222-4637",
            "fax_number": "802-222-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 ROUTE 302",
            "city": "WELLS RIVER",
            "state": "VT",
            "postal_code": "050819750",
            "telephone_number": "802-757-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE RIVERS HEALTH CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LITTLE RIVERS HEALTH CARE, INC.",
        "enumeration_date": "2018-03-15",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "BARTER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "802-222-4637"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0091985",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0124586",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042-0007871",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316165129",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Elizabeth Culver, APRN
• Stephen H. Genereaux, M.D.
• Elizabeth Sue Haskell, LPN
• Fay F Homan, M.D.
• Simone R Lessac Chenen, MD
• Little Rivers Health Care, Inc.
• Little Rivers Health Care, Inc.
• Sarah E. Metz, LICSW
• Alison Jamie O'Connor, ARNP
• Payton Chiropractic Center, Inc.

• Clinical Social Worker in Wells River, VT
• Providers in Wells River, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.