NPIMap

Individual provider Active NPI

Jon Patrick Ford, PA-C

  • Medical Physician Assistant
  • Burlington, VT
National Provider Identifier
1487090395
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
055-0031312 Issued in VT
Practice address
111 Colchester Ave
University of Vermont Medical Center
Burlington, VT 05401-1473
Phone
(802) 847-7911
Fax
(802) 847-5784
NPI assigned
May 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Medical Physician Assistant 363AM0700X 055-0031312 VT Primary

Addresses

Primary practice location

111 Colchester Ave
University of Vermont Medical Center
Burlington, VT 05401-1473

Mailing address

111 Colchester Ave
University of Vermont Medical Center
Burlington, VT 05401-1473
Phone (802) 847-7911

Other practice location 1

115 Porter Dr
Middlebury, VT 05753-8629
Phone (802) 388-4701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161019001719 VT Practitioner - Physician Assistant 8224262639 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Albany Medical College of Union University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter Hospital IncGroup PAC ID 1850365180, 116 clinicians

Practice addresses (Care Compare)

115 Porter Dr
Middlebury, VT 05753-8423
Phone (802) 388-4701

82 Catamount Park
Middlebury, VT 05753-1292
Phone (802) 388-7185

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
055-0031312VTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Porter Hospital Inc Current Accepting new patients
University of Vermont Medical Center Inc CurrentSince Sep 1, 2016 Accepting new patients
Fletcher Allen Health Care Inc Past Accepting new patients

Locations

111 Colchester Ave
#567
Burlington, VT 05401
Phone (802) 847-7911

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

Interoperability endpoints

  • Direct secure messaging: jford141412@direct.uvmhealth.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1368835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1487090395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "UNIVERSITY OF VERMONT MEDICAL CENTER",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-7911",
            "fax_number": "802-847-5784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "UNIVERSITY OF VERMONT MEDICAL CENTER",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-7911",
            "fax_number": "802-847-5784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Porter Dr",
            "address_purpose": "LOCATION",
            "city": "Middlebury",
            "state": "VT",
            "postal_code": "057538629",
            "country_code": "US",
            "telephone_number": "802-388-4701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD",
        "first_name": "JON",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-18",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VT",
            "license": "055-0031312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.