NPIMap

Organization Active NPI

Clara Martin Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Randolph, VT
National Provider Identifier
1356489207
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CLARA MARTIN CENTER
Practice address
11 S Main St
Randolph, VT 05060-1330
Phone
(802) 728-4466
Fax
(802) 728-4197
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Linda Chambers, LADC
Title
Executive Director
Phone
(802) 728-4466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

11 S Main St
Randolph, VT 05060-1330

Mailing address

11 S Main St
Randolph, VT 05060-1330
Phone (802) 728-4466

Other identifiers 1

IdentifierTypeStateIssuer
6060012MedicaidVT

National Provider Directory

National Provider Directory
Tax ID family
Clara Martin Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356489207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S MAIN ST",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050601330",
            "telephone_number": "802-728-4466",
            "fax_number": "802-728-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 S MAIN ST",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050601330",
            "telephone_number": "802-728-4466",
            "fax_number": "802-728-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARA MARTIN CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "802-728-4466",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6060012",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.