Active NPI
Blaine Ferris, MS
- Clinical Psychologist
- Burlington, VT
National Provider Identifier
1497823199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 097-0000532
- Practice address
- 300 Flynn Ave
Burlington, VT 05401-5301 - Phone
- (802) 658-0400
- Fax
- (802) 660-3665
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 097-0000532 | VT | Primary |
Addresses
Primary practice location
300 Flynn Ave
Burlington, VT 05401-5301
Mailing address
300 Flynn Ave
Burlington, VT 05401-5301
Phone (802) 658-0400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 097-0000532 | VT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497823199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 FLYNN AVE",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054015301",
"telephone_number": "802-658-0400",
"fax_number": "802-660-3665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 FLYNN AVE",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054015301",
"telephone_number": "802-658-0400",
"fax_number": "802-660-3665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERRIS",
"first_name": "BLAINE",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VT",
"license": "097-0000532",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.