NPIMap

Organization Active NPI

North Country Hospital & Health Center Inc

Doing business as North Country Dermatology Services

  • Dermatology Physician
  • Newport, VT
National Provider Identifier
1437280344
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Doing business as
North Country Dermatology Services
Practice address
189 Prouty Dr
Newport, VT 05855-9326
Phone
(802) 334-4111
Fax
(802) 334-3281
NPI assigned
Mar 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert L Fotter
Title
Chief Financial Officer
Phone
(802) 334-4111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

189 Prouty Dr
Newport, VT 05855-9326

Mailing address

189 Prouty Dr
Newport, VT 05855-9326
Phone (802) 334-4111

Other identifiers 4

IdentifierTypeStateIssuer
NORT00029083OtherVTBLUE CROSS BLUE SHIELD
1008041MedicaidVT
CA2318OtherVTMEDICARE RAIL ROAD
30201819MedicaidNH

Other names 1

  • North Country Dermatology Services Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437280344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 PROUTY DR",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058559326",
            "telephone_number": "802-334-4111",
            "fax_number": "802-334-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 PROUTY DR",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058559326",
            "telephone_number": "802-334-4111",
            "fax_number": "802-334-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY HOSPITAL & HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FOTTER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "802-334-4111",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NORT00029083",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008041",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "CA2318",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30201819",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Country Dermatology Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.