NPIMap

Organization Active NPI

Little Rivers Health Care, Inc.

  • Clinical Social Worker
  • Newbury, VT
National Provider Identifier
1356807465
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LITTLE RIVERS HEALTH CARE, INC.
Practice address
214 Pulaski Street
Newbury, VT 05051
Phone
(802) 757-2325
Fax
(802) 439-6783
NPI assigned
Feb 13, 2019
Last updated
May 24, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
LITTLE RIVERS HEALTH CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 24, 2023

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) 439-5321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

214 Pulaski Street
Newbury, VT 05051

Mailing address

PO Box 8
Newbury, VT 05051-0008
Phone (802) 222-3022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061003000417 VT Part B Supplier - Clinic/Group Practice 8224031497 Receives reassigned benefits from 41 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wells River, VT; Bradford, VT; Thetford, VT; Newbury, VT; East Corinth, VT
O20190516000779 VT Part A Provider - Federally Qualified Health Center (FQHC) 8224031497 Practice locations: Newbury, VT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356807465. Details of each certification follow.

Federally qualified health center certification: CCN 471881

Legal name
LITTLE RIVERS HEALTH CARE, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 26, 2022
Last certification
Sep 26, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 12, 2003 in VT
Enrollment address
214 Pulaski Street
Newbury, VT 50510068

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Little Rivers Health Care12 organizations share this tax ID, including this one
Part of
Little Rivers Health Care

Other organizations with this tax ID 11

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

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bonnie L Tuttle Individual W-2 Managing EmployeeOffice Manager Feb 13, 2019
Operational/Managerial ControlOffice Manager Feb 13, 2019
Timothy Ross Individual Corporate DirectorBoard Member Feb 13, 2019
Carole C Freeman Individual Corporate DirectorBoard Member Jan 1, 2022
Carrie Bogie Individual Corporate DirectorBoard Member Feb 13, 2019
Dale Gephart Individual Corporate DirectorBoard Member Feb 13, 2019
Margaret Burmeister Individual Corporate DirectorBoard Member Jan 1, 2022
Matthew Knisley Individual Corporate DirectorBoard Member Jan 1, 2022
Andrew I Barter Individual Corporate OfficerCeo Aug 15, 2022
W-2 Managing EmployeeCeo Aug 15, 2022
Operational/Managerial ControlCeo Aug 15, 2022
Jill Skochdopole Individual Corporate DirectorBoard Member Jan 1, 2022
Pamela Smith Individual Corporate DirectorBoard Member Jan 1, 2022
Darren Sherburne Individual Corporate DirectorBoard Member Jan 1, 2022
Monique Priestley Individual Corporate DirectorBoard Member Feb 13, 2019
Scott Labun Individual Corporate DirectorBoard Member Jan 1, 2022
Brynn Cole Individual Corporate DirectorBoard Member Feb 13, 2019
William a Campbell Individual Corporate DirectorBoard Member Jan 1, 2022
Kelsey Root-Winchester Individual Corporate DirectorBoard Member Jan 1, 2022

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1356807465",
    "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": "802-222-3022",
            "fax_number": "802-439-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 PULASKI STREET",
            "city": "NEWBURY",
            "state": "VT",
            "postal_code": "05051",
            "telephone_number": "802-757-2325",
            "fax_number": "802-439-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE RIVERS HEALTH CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LITTLE RIVERS HEALTH CARE, INC.",
        "enumeration_date": "2019-02-13",
        "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": "802-439-5321"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newbury, VT

Sources for this page

Verify at the official NPI Registry.