NPIMap

Organization Active NPI

Community Health Centers of the Rutland Region, Inc.

Doing business as Community Dental

  • Dentist
  • Rutland, VT
National Provider Identifier
1437364759
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC.
Doing business as
Community Dental
Community Health Centers of the Rutland Region Dental Clinic
Practice address
69 Allen St Ste 10
Rutland, VT 05701-4564
Phone
(802) 774-5050
NPI assigned
May 11, 2007
Last updated
Aug 1, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Authorized official

Name
Mr. Grant Whitmer
Title
Executive Director
Phone
(802) 468-5641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

69 Allen St Ste 10
Rutland, VT 05701-4564

Mailing address

275 Route 30 N
Bomoseen, VT 05732-9647
Phone (802) 468-5641

Other practice location 1

2987 Vt Route 22A
Shoreham, VT 05770-9728
Phone (802) 897-7000

Other names 2

  • Community Dental Doing business as
  • Community Health Centers of the Rutland Region Dental Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191011001136 VT Part B Supplier - Clinic/Group Practice 2961467386 Receives reassigned benefits from 5 practitioners
Practice locations: Rutland, VT

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Community Health Centers of5 organizations share this tax ID, including this one
Part of
Community Health Centers of

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564617600000",
    "number": "1437364759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 ROUTE 30 N",
            "city": "BOMOSEEN",
            "state": "VT",
            "postal_code": "057329647",
            "telephone_number": "802-468-5641",
            "fax_number": "802-468-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 ALLEN ST STE 10",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014564",
            "telephone_number": "802-774-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2987 Vt Route 22A",
            "address_purpose": "LOCATION",
            "city": "Shoreham",
            "state": "VT",
            "postal_code": "057709728",
            "country_code": "US",
            "telephone_number": "802-897-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC",
        "enumeration_date": "2007-05-11",
        "last_updated": "2019-08-01",
        "status": "A",
        "authorized_official_last_name": "WHITMER",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "802-468-5641",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Health Centers of the Rutland Region Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rutland, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.