Individual provider Active NPI

David R Charnock, M.D.

  • Otolaryngology Physician
  • Rutland, VT
National Provider Identifier
1336149160
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
042-0008622 Issued in VT
Practice address
69 Allen St
Suite 4
Rutland, VT 05701-4564
Phone
(802) 775-3314
Fax
(802) 775-9617
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 042-0008622 VT Primary

Addresses

Primary practice location

69 Allen St
Suite 4
Rutland, VT 05701-4564

Mailing address

69 Allen St
Suite 1
Rutland, VT 05701-4564
Phone (802) 775-3314

Other identifiers 1

IdentifierTypeStateIssuer
0VN0447MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060217000569 VT Practitioner - Otolaryngology 2062499676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0008622VTMDOtolaryngology Physician

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1336149160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 ALLEN ST",
            "address_2": "SUITE 1",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014564",
            "telephone_number": "802-775-3314",
            "fax_number": "802-775-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 ALLEN ST",
            "address_2": "SUITE 4",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014564",
            "telephone_number": "802-775-3314",
            "fax_number": "802-775-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARNOCK",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "VT",
            "license": "042-0008622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN0447",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.