NPIMap

Organization Active NPI

North Country Hospital & Health Center Inc

Doing business as North Country Pediatrics

  • Pediatrics Physician
  • Newport, VT
National Provider Identifier
1457746661
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
832 Issued in VT
Legal business name
NORTH COUNTRY HOSPITAL & HEALTH CENTER INC
Doing business as
North Country Pediatrics
Practice address
121 Medical Village Dr
Newport, VT 05855-9834
Phone
(802) 334-4111
Fax
(802) 334-3281
NPI assigned
Apr 3, 2015
Last updated
Sep 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Authorized official

Name
Deborah L Brown
Title
Enrollment Specilist
Phone
(802) 334-3210

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 832 VT Primary
Durable Medical Equipment & Medical Supplies 332B00000X 832 VT

Addresses

Primary practice location

121 Medical Village Dr
Newport, VT 05855-9834

Mailing address

121 Medical Village Dr
Newport, VT 05855-9834
Phone (802) 334-5929

Other names 1

  • North Country Pediatrics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457746661. Details of each certification follow.

Rural health clinic certification: CCN 473814

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
NORTH COUNTRY PEDIATRICS
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Nov 14, 1991
Last certification
Oct 17, 2023
Ownership / control type
2B
Most recent change of ownership
Apr 1, 2015 (1 total)
Facility address
121 Medical Village Drive
Newport, VT 05855

National Provider Directory

National Provider Directory

Locations

121 Medical Village Dr
Newport, VT 05855
Phone (802) 334-5929

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1457746661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 MEDICAL VILLAGE DR",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058559834",
            "telephone_number": "802-334-5929",
            "fax_number": "802-487-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 MEDICAL VILLAGE DR",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058559834",
            "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": "2015-04-03",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ENROLLMENT SPECILIST",
        "authorized_official_telephone_number": "802-334-3210"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "VT",
            "license": "832",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VT",
            "license": "832",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Country Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Country Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newport, VT

Sources for this page

Verify at the official NPI Registry.