Active NPI
Johanna Hauser, PA
- Physician Assistant
- Williston, VT
National Provider Identifier
1366489122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 055-0030027
- Practice address
- 75 Talcott Rd
Suite 10
Williston, VT 05495-8121 - Phone
- (802) 879-4800
- NPI assigned
- Jun 1, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 055-0030027 | VT | Primary |
Addresses
Primary practice location
75 Talcott Rd
Suite 10
Williston, VT 05495-8121
Mailing address
128 Lakeside Ave
Suite 301
Burlington, VT 05401-4939
Phone (802) 448-9719
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 900224 | Medicaid | VT |
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 |
|---|---|---|---|
| 055-0030027 | VT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Planned Parenthood of Northern New England | Past | Accepting new patients | |
| Planned Parenthood of Northern New England | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Non-Pharmacy Dispensing Site
- Williston, VT
- NPI 1073904199
-
- Non-Pharmacy Dispensing Site
- Barre, VT
- NPI 1851782015
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335398400000",
"number": "1366489122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 LAKESIDE AVE",
"address_2": "SUITE 301",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054014939",
"telephone_number": "802-448-9719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 TALCOTT RD",
"address_2": "SUITE 10",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054958121",
"telephone_number": "802-879-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUSER",
"first_name": "JOHANNA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-01",
"last_updated": "2012-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VT",
"license": "055-0030027",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "900224",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williston, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.