NPIMap

Organization Active NPI

Northwestern Medical Center, Inc.

Doing business as Northwestern Georgia Health Center

  • Clinic/Center
  • Fairfax, VT
National Provider Identifier
1417287665
Registry record updated Oct 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NORTHWESTERN MEDICAL CENTER, INC.
Doing business as
Northwestern Georgia Health Center
Practice address
4178 Highbridge Rd
Fairfax, VT 05454-5446
Phone
(802) 752-1930
Fax
(802) 524-2867
NPI assigned
Jan 12, 2010
Last updated
Oct 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2018

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

4178 Highbridge Rd
Fairfax, VT 05454-5446

Mailing address

133 Fairfield St
Saint Albans, VT 05478-1726
Phone (802) 524-5911

Other identifiers 1

IdentifierTypeStateIssuer
1017250MedicaidVT

Other names 2

  • Northwestern Georgia Health Center Doing business as
  • Northwestern Medical Center/Georgia Health Care Other name

National Provider Directory

National Provider Directory
Tax ID family
Northwestern Medical Ce36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540512000000",
    "number": "1417287665",
    "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": "802-524-5911",
            "fax_number": "802-524-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4178 HIGHBRIDGE RD",
            "city": "FAIRFAX",
            "state": "VT",
            "postal_code": "054545446",
            "telephone_number": "802-752-1930",
            "fax_number": "802-524-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-12",
        "last_updated": "2018-10-26",
        "status": "A",
        "authorized_official_last_name": "PIGEON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "802-524-8954"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1017250",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwestern Georgia Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northwestern Medical Center/Georgia Health Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairfax, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.