Individual provider Active NPI

Ronald S Woodworth, DO

  • Family Medicine Physician
  • Bennington, VT
National Provider Identifier
1366499782
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0320000265 Issued in VT
Practice address
140 Hospital Dr
Suite 300
Bennington, VT 05201-5009
Phone
(802) 447-1564
Fax
(802) 447-3346
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0320000265 VT Primary

Addresses

Primary practice location

140 Hospital Dr
Suite 300
Bennington, VT 05201-5009

Mailing address

140 Hospital Dr Ste 300
PO Box 1432
Bennington, VT 05201-5018
Phone (802) 447-1564

Other identifiers 2

IdentifierTypeStateIssuer
0005198MedicaidVT
5198OtherVTBCBS 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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
0320000265VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Vermont Medical Center Inc. Family Medicine Past Accepting new patients
Southwestern Vermont Medical Center Inc. 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.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366499782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 HOSPITAL DR STE 300",
            "address_2": "PO BOX 1432",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052015018",
            "telephone_number": "802-447-1564",
            "fax_number": "802-447-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 HOSPITAL DR",
            "address_2": "SUITE 300",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052015009",
            "telephone_number": "802-447-1564",
            "fax_number": "802-447-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODWORTH",
        "first_name": "RONALD",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "0320000265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005198",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS VT",
            "identifier": "5198",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bennington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.