NPIMap

Individual provider Active NPI

Jessica L Macleod, APRN

  • Adult Health Nurse Practitioner
  • Berlin, VT
National Provider Identifier
1336469337
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
101-0068303 Issued in VT
Practice address
142 Woodridge Drive
Berlin, VT 05602-9516
Phone
(802) 371-4700
Fax
(802) 371-4720
NPI assigned
Jun 2, 2010
Last updated
Dec 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 101-0068303 VT Primary

Addresses

Primary practice location

142 Woodridge Drive
Berlin, VT 05602-9516

Mailing address

PO Box 547
Att: CVMC Finance Dept
Barre, VT 05641-0547
Phone (802) 371-4700

Other identifiers 1

IdentifierTypeStateIssuer
1017871MedicaidVT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101015000476 VT Practitioner - Nurse Practitioner 0244423804 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeastern Vermont Regional Hospital IncGroup PAC ID 3678481405, shared by 15 NPIs, 104 clinicians

Practice addresses (Care Compare)

195 Industrial Pkwy
Lyndonville, VT 05851-4511
Phone (802) 748-9501

714 Breezy Hill Rd
St Johnsbury, VT 05819-8882
Phone (802) 748-7500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
101-0068303VTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Central Vermont Medical Center Inc CurrentSince Jan 2, 2015 Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Jun 26, 2012 Accepting new patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Jan 15, 2012 Accepting new patients
Northeastern Vermont Regional Hospital Inc Current Accepting new patients
Central Vermont Medical Center Inc Current Accepting new patients
Northeastern Vermont Regional Hospital Inc CurrentSince Jan 15, 2012 Accepting new patients
Northeastern Vermont Regional Hospital, Inc. Past Accepting new patients

Locations

130 Fisher Rd
Barre, VT 05641
Phone (802) 371-4235

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

142 Woodridge Rd
Berlin, VT 05602
Phone (802) 371-4700

195 Industrial Pkwy
Lyndonville, VT 05851

1315 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 748-3638

714 Breezy Hill Rd
St Johnsbury, VT 05819
Phone (802) 748-5126

714 Breezy Hill Rd
Ste 1
St Johnsbury, VT 05819
Phone (802) 748-7500

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1336469337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "address_2": "ATT: CVMC FINANCE DEPT",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-371-4700",
            "fax_number": "802-371-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 WOODRIDGE DRIVE",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029516",
            "telephone_number": "802-371-4700",
            "fax_number": "802-371-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACLEOD",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VT",
            "license": "101-0068303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017871",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, VT

Sources for this page

Verify at the official NPI Registry.