Dr. Shellie Burdick LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

DR. SHELLIE BURDICK LLC

Practice address

10 Bank St
North Bennington, VT 05257-9101

Phone

(802) 732-3010

Fax

(802) 732-3010

NPI assigned

Aug 8, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Shellie Burdick, DONPI 1376839332

Title

Owner

Phone

(802) 732-3010

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

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.

• Shellie Burdick, D.O.

  • Family Medicine Physician
  • Pownal, VT
  • NPI 1376839332
  Medicare reassignment Care Compare group NPD Authorized official
• Charisma Ann Lanez, D.O.

  • Family Medicine Physician
  • Jackson, NJ
  • NPI 1942637988

  VT

  Medicare reassignment Care Compare group NPD
• John Eric Hearst, MD

  • Family Medicine Physician
  • Bennington, VT
  • NPI 1972553766
  NPD
• Avery Wood, MD

  • Family Medicine Physician
  • North Bennington, VT
  • NPI 1740230614
  NPD

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1376226175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11",
            "city": "NORTH BENNINGTON",
            "state": "VT",
            "postal_code": "052570011",
            "telephone_number": "802-732-3010",
            "fax_number": "802-732-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BANK ST",
            "city": "NORTH BENNINGTON",
            "state": "VT",
            "postal_code": "052579101",
            "telephone_number": "802-732-3010",
            "fax_number": "802-732-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SHELLIE BURDICK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "BURDICK",
        "authorized_official_first_name": "SHELLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-732-3010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Alli, LADC LCMHC
• Andrea J Alli Counseling PLLC
• Avery Wood MD LLC
• Crowers Counseling LLC
• Erika Dawn Crowers, LICSW
• Gwendolyn Marie Eagan, MS, RD
• Allison Elwell
• Meghan Gunn, M.D.
• Matthew Reed Macaulay, LICSW
• Matt Macaulay Licsw LLC

• Primary Care Clinic/Center in North Bennington, VT
• Providers in North Bennington, VT by specialty
• Primary Care Clinic/Center in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.