NPIMap

Organization Active NPI

Central Vermont Medical Center Inc

  • General Acute Care Hospital
  • Berlin, VT
National Provider Identifier
1508845637
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
666 Issued in VT
Legal business name
CENTRAL VERMONT MEDICAL CENTER INC
Practice address
130 Fisher Rd
Berlin, VT 05602-9516
Phone
(802) 371-4100
Fax
(802) 371-4488
NPI assigned
Jan 17, 2006
Last updated
Feb 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Authorized official

Name
Cheyenne Holland
Title
Cfo
Phone
(802) 371-4109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 666 VT Primary

Addresses

Primary practice location

130 Fisher Rd
Berlin, VT 05602-9516

Mailing address

PO Box 547
Barre, VT 05641-0547
Phone (802) 371-4100

Other identifiers 1

IdentifierTypeStateIssuer
0470001MedicaidVT

Other names 1

  • Central Vermont Medical Center Inc. Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service Other Ciox Health

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050809000650 VT Part A Provider - Hospital 9335138817 Practice locations: Waterbury, VT; Waterbury Center, VT; Waitsfield, VT; Northfield, VT; Montpelier, VT; Berlin, VT; Barre, VT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508845637. Details of each certification follow.

Hospital certification: CCN 470001

Legal name
CENTRAL VERMONT MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Oct 1, 1967
Last certification
Mar 2, 2016
Beds
175
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Mar 1, 1984 in VT
Enrollment address
130 Fisher Rd
Berlin, VT 56029516
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Central Vermont Medical CenterCCN 470001 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

130 Fisher Rd
Berlin, VT 05602
Phone (802) 225-5820

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michael Dellipriscoli Individual Corporate Director Jan 1, 2024
R Scott Nelson Individual Corporate Director Jan 1, 2024
Lisa Muller Individual Corporate Director Dec 1, 2021
Constance Colman Individual Corporate Director Apr 26, 2018
Kristin Carlson Individual Corporate Director Jan 1, 2025
Kimberly Patnaude Individual Corporate Officer Mar 15, 2021
W-2 Managing Employee Mar 15, 2021
Joyce Judy Individual Corporate Director Dec 12, 2013
The University of Vermont Health Network Inc. Organization, Burlington, VT Non-profit 5% Or Greater Direct Ownership Interest Nov 17, 2014 100%
Sunil Eappen Individual Corporate Director Nov 28, 2022
Erica Metzger Hare Individual Corporate Director Jan 1, 2023
Ryan D Clouser Individual Corporate Director Jan 1, 2024
Anna T Noonan Individual Corporate Director Jul 24, 2017
W-2 Managing Employee Jul 24, 2017
Operational/Managerial Control Jul 24, 2017
Joan Marie Misek Individual Corporate Director Dec 1, 2019

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 39

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.

View all 39

Affiliated clinicians 686

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 686

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708041600000",
    "number": "1508845637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-371-4100",
            "fax_number": "802-371-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FISHER RD",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029516",
            "telephone_number": "802-371-4100",
            "fax_number": "802-371-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL VERMONT MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-17",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "CHEYENNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "802-371-4109"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "VT",
            "license": "666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0470001",
            "state": "VT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.cioxhealth.com:8291/Gateway/DocumentSubmission/1_1/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "esmd.cioxhealth.com and OID is '2.16.840.1.113883.3.6635.1.1'",
            "affiliationName": "Ciox Health",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "925 N Point Pkwy",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300055210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Central Vermont Medical Center Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Berlin, VT

Sources for this page

Verify at the official NPI Registry.