Vergennes Residential Care, Inc.

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

0311 Issued in VT

Legal business name

VERGENNES RESIDENTIAL CARE, INC.

Practice address

34 North St
Vergennes, VT 05491-1108

Phone

(802) 877-3562

Fax

(802) 877-3562

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Timothy F Buskey Sr.

Title

Administrator

Phone

(802) 877-3562

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508936733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 NORTH ST",
            "city": "VERGENNES",
            "state": "VT",
            "postal_code": "054911108",
            "telephone_number": "802-877-3562",
            "fax_number": "802-877-3562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 NORTH ST",
            "city": "VERGENNES",
            "state": "VT",
            "postal_code": "054911108",
            "telephone_number": "802-877-3562",
            "fax_number": "802-877-3562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERGENNES RESIDENTIAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUSKEY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "802-877-3562",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "VT",
            "license": "0311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047R038",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047W234",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047W345",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Custodial Care Facility in Vergennes, VT
• Providers in Vergennes, VT by specialty
• Custodial Care Facility in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.