Individual provider Active NPI

Cary J Stratford, PA-C

  • Medical Physician Assistant
  • Windsor, VT
National Provider Identifier
1508852096
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
055-0030554 Issued in VT
Practice address
289 County Rd
Windsor, VT 05089-9000
Phone
(802) 674-7220
Fax
(802) 674-7006
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 055-0030554 VT Primary

Addresses

Primary practice location

289 County Rd
Windsor, VT 05089-9000

Mailing address

289 County Rd
Windsor, VT 05089-9000
Phone (802) 674-7220

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
055-0030554VTMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508852096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 COUNTY RD",
            "city": "WINDSOR",
            "state": "VT",
            "postal_code": "050899000",
            "telephone_number": "802-674-7220",
            "fax_number": "802-674-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 COUNTY RD",
            "city": "WINDSOR",
            "state": "VT",
            "postal_code": "050899000",
            "telephone_number": "802-674-7220",
            "fax_number": "802-674-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRATFORD",
        "first_name": "CARY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VT",
            "license": "055-0030554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, 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.

Verify at the official NPI Registry.