Samantha Burnham Ingerick, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

101.0134299 Issued in VT

Practice address

4384 Main Street
Manchester, VT 05254-9207

Phone

(802) 768-9136

Fax

(802) 662-2173

NPI assigned

Aug 18, 2014

Last updated

Oct 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Smantha Burnham Former name

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: singerick622862@direct.dartmouth-hitchcock.org

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.

• Windsor Hospital Corporation

  dba Mt Ascutney Hospital and Health Center

  • Internal Medicine Physician
  • Windsor, VT
  • NPI 1841287984
  Medicare reassignment NPD
• Windsor Hospital Corporation

  dba Mt Ascutney Hospital Acute

  • Critical Access Hospital
  • Windsor, VT
  • NPI 1922095918
  Medicare reassignment NPD
• Taconic Integrative Psychiatric Services, PLLC

  • Psychiatry Physician
  • Manchester, VT
  • NPI 1881227452
  NPD
• Windsor Hospital Corporation

  dba Mt Ascutney Hospital and Health Center

  • Rehabilitation Hospital
  • Windsor, VT
  • NPI 1679560668
  NPD

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1457750234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255",
            "city": "MANCHESTER",
            "state": "VT",
            "postal_code": "052540255",
            "telephone_number": "802-768-9136",
            "fax_number": "802-662-2173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4384 MAIN STREET",
            "city": "MANCHESTER",
            "state": "VT",
            "postal_code": "052549207",
            "telephone_number": "802-768-9136",
            "fax_number": "802-662-2173"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "289 County Rd",
            "address_purpose": "LOCATION",
            "city": "Windsor",
            "state": "VT",
            "postal_code": "050899000",
            "country_code": "US",
            "telephone_number": "802-674-7337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INGERICK",
        "first_name": "SAMANTHA",
        "middle_name": "BURNHAM",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382385-1",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NH",
            "license": "088196-23",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VT",
            "license": "101.0134299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SMANTHA",
            "last_name": "BURNHAM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Brigante, LICENSED COSMATIC
• John R. De Bitetto, MSPT
• Equinox Family Medicine, PC
• Peggy Sheehan Gregory, LICSW
• Donald Henry Grenier Jr., MSN, PMHNP
• Elizabeth Jorgensen
• Maxwell Levis, PHD, LICSW
• Main Physical Therapy LLC
• Hugh Main, PT
• Mason Dental PC (Mason Dental)

• Pediatric Nurse Practitioner in Manchester, VT
• Providers in Manchester, VT by specialty
• Pediatric Nurse Practitioner in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.