Individual provider Active NPI

Elizabeth G Dunbar, PA-C

  • Physician Assistant
  • Waterbury Center, VT
National Provider Identifier
1366975328
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1593 Issued in NH
Practice address
228 E Harvey Farm Rd
Waterbury Center, VT 05677-7117
Phone
(802) 498-4133
NPI assigned
Apr 6, 2017
Last updated
May 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 055.0031370 VT
Physician Assistant 363A00000X 1593 NH Primary

Addresses

Primary practice location

228 E Harvey Farm Rd
Waterbury Center, VT 05677-7117

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-8456

Other practice location 1

1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-8456

Other names 1

  • Elizabeth G Libby Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180127000062 VT Practitioner - Physician Assistant 9830469857 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1593NHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Central Vermont Medical Center Inc CurrentSince Feb 2, 2021 Accepting new patients
Central Vermont Medical Center Inc CurrentSince Feb 2, 2021 Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

130 Fisher Rd
Barre, VT 05641
Phone (802) 371-4235

77 Vine St
Barre, VT 05641
Phone (802) 225-1266

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

Interoperability endpoints

  • Direct secure messaging: edunbar410790@direct.uvmhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1366975328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037560001",
            "telephone_number": "603-650-8456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 E HARVEY FARM RD",
            "city": "WATERBURY CENTER",
            "state": "VT",
            "postal_code": "056777117",
            "telephone_number": "802-498-4133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "603-650-8456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNBAR",
        "first_name": "ELIZABETH",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-06",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031370",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "LIBBY",
            "middle_name": "G",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waterbury Center, VT

Sources for this page

Verify at the official NPI Registry.