NPIMap

Organization Active NPI

Champlain Valley Foot & Ankle, P.C.

  • Foot Surgery Podiatrist
  • Essex Junction, VT
National Provider Identifier
1366528259
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
056-0000174 Issued in VT
Legal business name
CHAMPLAIN VALLEY FOOT & ANKLE, P.C.
Practice address
55 Main St
Ste 1
Essex Junction, VT 05452-3191
Phone
(802) 879-7992
Fax
(802) 879-6969
NPI assigned
Oct 31, 2006
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
Dr. Stephen John Merena, DPMNPI 1194758557
Title
President
Phone
(802) 879-7992

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 056-0000174 VT Primary

Addresses

Primary practice location

55 Main St
Ste 1
Essex Junction, VT 05452-3191

Mailing address

55 Main St
Ste 1
Essex Junction, VT 05452-3191
Phone (802) 879-7992

Other identifiers 4

IdentifierTypeStateIssuer
5468501OtherVTFLETCHER ALLEN PREFERRED
CHAM00068673OtherVTBC/BS
0VN3709MedicaidVT
788692OtherVTMVP

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366528259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 MAIN ST",
            "address_2": "STE 1",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054523191",
            "telephone_number": "802-879-7992",
            "fax_number": "802-879-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 MAIN ST",
            "address_2": "STE 1",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054523191",
            "telephone_number": "802-879-7992",
            "fax_number": "802-879-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPLAIN VALLEY FOOT & ANKLE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MERENA",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "802-879-7992",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VT",
            "license": "056-0000174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLETCHER ALLEN PREFERRED",
            "identifier": "5468501",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "CHAM00068673",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN3709",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "788692",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex Junction, 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.