Individual provider Active NPI

Anna McCloy, MD

  • Pediatrics Physician
  • Rutland, VT
National Provider Identifier
1386878148
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
042-0012499 Issued in VT
Practice address
1 General Wing Rd
Rutland, VT 05701-4681
Phone
(802) 773-9131
Fax
(802) 773-1551
NPI assigned
May 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X ME
Pediatrics Physician 208000000X 042-0012499 VT Primary

Addresses

Primary practice location

1 General Wing Rd
Rutland, VT 05701-4681

Mailing address

71 Allen St
Suite 403
Rutland, VT 05701-4570
Phone (802) 772-4414

Other identifiers 2

IdentifierTypeStateIssuer
1021096MedicaidVT
04176532MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160630000606 VT Practitioner - Pediatric Medicine 3476845017 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0012499VTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Apr 26, 2016 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Apr 26, 2016 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Apr 26, 2016 Accepting new patients
Community Health Centers of the Rutland Region Inc Current Accepting new patients
Community Health Centers of the Rutland Region, Inc. Pediatrics CurrentSince Apr 26, 2016 Accepting new patients
Rutland Hospital, Inc. Past Accepting new patients

Locations

275 VT 30 N
Bomoseen, VT 05732
Phone (802) 468-5641

215 Stratton Rd
Rutland, VT 05701
Phone (802) 773-3386

1 General Wing Rd
Rutland, VT 05701
Phone (802) 773-9131

71 Allen St
Ste 402
Rutland, VT 05701
Phone (800) 468-9118

71 Allen St
Ste 403
Rutland, VT 05701
Phone (802) 772-4414

2987 Vt Route 22A
Shoreham, VT 05770
Phone (802) 897-7000

278 Vt Route 149
West Pawlet, VT 05775
Phone (800) 468-9118

Interoperability endpoints

  • Direct secure messaging: amccloy@chcrr.medentdirect.com

Organizations & group practices 7

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": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1386878148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 ALLEN ST",
            "address_2": "SUITE 403",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014570",
            "telephone_number": "802-772-4414",
            "fax_number": "802-772-7973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENERAL WING RD",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014681",
            "telephone_number": "802-773-9131",
            "fax_number": "802-773-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLOY",
        "first_name": "ANNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-08",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "ME",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VT",
            "license": "042-0012499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021096",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04176532",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.