Active NPI
Susan Whitman, PA
- Medical Physician Assistant
- Burlington, VT
National Provider Identifier
1326149220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0550030747
- Practice address
- 425 Pearl St
Burlington, VT 05401-3308 - Phone
- (802) 656-3350
- Fax
- (802) 656-8001
- NPI assigned
- Sep 26, 2006
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0550030747 | VT | Primary |
Addresses
Primary practice location
425 Pearl St
Burlington, VT 05401-3308
Mailing address
1450 Johnnie Brook Rd
Richmond, VT 05477-4412
Phone (802) 578-5146
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000241 | Medicaid | VT | |
| 69001 | Other | BLUE CROSS BLUE SHIELD | |
| 0030747 | Other | FLETCHER ALLEN PREFERRED | |
| 69001 | Other | VERMONT MANAGED CARE | |
| 793628 | Other | MVP |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0550030747 | VT | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346716800000",
"number": "1326149220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 JOHNNIE BROOK RD",
"city": "RICHMOND",
"state": "VT",
"postal_code": "054774412",
"telephone_number": "802-578-5146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 PEARL ST",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054013308",
"telephone_number": "802-656-3350",
"fax_number": "802-656-8001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITMAN",
"first_name": "SUSAN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2012-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "VT",
"license": "0550030747",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000241",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "69001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLETCHER ALLEN PREFERRED",
"identifier": "0030747",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VERMONT MANAGED CARE",
"identifier": "69001",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "793628",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.