NPIMap

Organization Active NPI

Northwestern Medical Center Inc

Doing business as Northwestern Medical Center

  • General Acute Care Hospital
  • Saint Albans, VT
National Provider Identifier
1386689875
Registry record updated May 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
NORTHWESTERN MEDICAL CENTER INC
Doing business as
Northwestern Medical Center
Practice address
133 Fairfield St
Saint Albans, VT 05478-1726
Phone
(802) 524-1076
Fax
(802) 524-8803
NPI assigned
Jun 18, 2006
Last updated
May 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2015

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

Authorized official

Name
Mary Pigeon
Title
Payor Credentialing Specialist
Phone
(802) 524-8954

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X VT Primary
Institutional Pharmacy 3336I0012X 0370001670 VT

Addresses

Primary practice location

133 Fairfield St
Saint Albans, VT 05478-1726

Mailing address

133 Fairfield St
Saint Albans, VT 05478-1726
Phone (802) 524-1076

Other identifiers 2

IdentifierTypeStateIssuer
2101324OtherPK
470024MedicaidVT

Other names 1

  • NORTHWESTERN MEDICAL CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061201000424 VT Part A Provider - Hospital 5496714313 Practice locations: Saint Albans, VT
O20210617000273 VT Part A Provider - Hospital 5496714313 Practice locations: Saint Albans, VT

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1386689875. Details of each certification follow.

Hospital certification: CCN 470024

Legal name
NORTHWESTERN MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 30, 1977
Last certification
Apr 2, 2008
Beds
70
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Jul 30, 1977 in VT
Enrollment address
133 Fairfield St
Saint Albans, VT 54781726
Other Hospital Practice Location
Hospital subgroups
Acute care, Swing-bed approved

Hospital certification: CCN 47U024

Legal name
NORTHWESTERN MEDICAL CENTER INC
Organization structure
CorporationProprietary
Incorporated
Jul 30, 1977 in VT
Enrollment address
133 Fairfield St
Saint Albans, VT 54781726
Other Hospital Practice Location
Hospital subgroups
Swing-bed approved

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Northwestern Medical Center IncCCN 470024 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1 Crest Rd
Ste Cstc
Saint Albans, VT 05478

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jake Holzscheiter Individual Corporate OfficerBoard Member Jan 1, 2017
Corey Parent Individual Corporate Officer May 9, 2023
John P Minadeo Individual Corporate OfficerCmqo Apr 1, 2020 100%
Operational/Managerial ControlCmqo Apr 1, 2020 100%
Nick Hadden Individual Corporate OfficerBoard Member Jan 1, 2016
Karyn Rocheleau Individual Corporate OfficerBoard Member Jan 1, 2018
Rajvinder S Khela Individual Corporate Officer Nov 20, 2020
Stephanie Breault Individual Corporate DirectorDirector of Finance Apr 1, 2020 100%
W-2 Managing EmployeeDirector of Finance Apr 1, 2020 100%
Coleen Condon Individual Corporate Officer May 9, 2023
Barb Toof Individual Corporate Officer May 9, 2023
Erin Creley Individual Corporate Officer May 9, 2023
Meredith Roberts Individual Corporate Officer Nov 5, 2020
John Casavant Individual Corporate OfficerBoard Member Jan 1, 2018
Megan B Smith Individual Corporate DirectorManager, Patient Financial Services Apr 1, 2020 100%
W-2 Managing EmployeeManager, Patient Financial Services Apr 1, 2020 100%
Dawn Bugbee Individual Corporate OfficerBoard Member Jan 1, 2016
Joel Benware Individual W-2 Managing EmployeeVP Is & Compliance Mar 5, 2018 100%
Ovation Health Organization, Brentwood, TN LLC Operational/Managerial Control Nov 1, 2006
Jane Catton Individual Corporate Officer Dec 1, 2012

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

Affiliated clinicians 536

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 536

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1386689875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 FAIRFIELD ST",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054781726",
            "telephone_number": "802-524-1076",
            "fax_number": "802-524-8803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 FAIRFIELD ST",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054781726",
            "telephone_number": "802-524-1076",
            "fax_number": "802-524-8803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "PIGEON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PAYOR CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "802-524-8954"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "VT",
            "license": null,
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "VT",
            "license": "0370001670",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2101324",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470024",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHWESTERN MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Albans, VT

Sources for this page

Verify at the official NPI Registry.