NPIMap

Individual provider Active NPI

Jennifer Diane Wetherald, DO

  • Obstetrics & Gynecology Physician
  • St Johnsbury, VT
National Provider Identifier
1407249733
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
20A17315 Issued in CA
Practice address
1315 Hospital Dr
St Johnsbury, VT 05819-9210
Phone
(802) 748-7300
Fax
(802) 748-4321
NPI assigned
Mar 11, 2015
Last updated
Apr 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 20A17315 CA Primary

Addresses

Primary practice location

1315 Hospital Dr
St Johnsbury, VT 05819-9210

Mailing address

PO Box 905
St Johnsbury, VT 05819-0905
Phone (802) 748-8141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210112001603 NC Practitioner - Obstetrics/Gynecology 8325377559 Reassigns benefits to 3 organizations
I20250303002518 VT Practitioner - Obstetrics/Gynecology 8325377559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1315 Hospital Dr
Saint Johnsbury, VT 05819-9210

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A17315CAMDObstetrics & Gynecology Physician
17315CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Group, Inc. Current Accepting new patients
Rural Health Group, Inc. CurrentSince Sep 22, 2023 Accepting new patients
Rural Health Group, Inc. CurrentSince Dec 4, 2020 Accepting new patients
Rural Health Group, Inc. Current Accepting new patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Feb 1, 2025 Accepting new patients
Rural Health Group, Inc. CurrentSince Dec 4, 2020 Accepting new patients
Northeastern Vermont Regional Hospital, Inc Obstetrics & Gynecology CurrentSince Feb 1, 2025 Accepting new patients
Rural Health Group, Inc. CurrentSince Sep 22, 2023 Accepting new patients
Northeastern Vermont Regional Hospital, Inc Past Accepting new patients

Locations

1096 E 10th St
Roanoke Rapids, NC 27870
Phone (252) 535-3516

1381 Medical Center Dr
Roanoke Rapids, NC 27870
Phone (252) 535-1414

2066 NC Highway 125
Roanoke Rapids, NC 27870
Phone (252) 536-5000

250 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-9699

270 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-6816

1315 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 748-3638

Organizations & group practices 9

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1407249733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 905",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058190905",
            "telephone_number": "802-748-8141",
            "fax_number": "802-748-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 HOSPITAL DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199210",
            "telephone_number": "802-748-7300",
            "fax_number": "802-748-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETHERALD",
        "first_name": "JENNIFER",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-11",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "20A17315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johnsbury, VT

Sources for this page

Verify at the official NPI Registry.