Individual provider Active NPI

Susan Betty Carol, MD

  • General Practice Physician
  • St. Albans, VT
National Provider Identifier
1508963596
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
042.0013949 Issued in VT
Practice address
133 Faifield St.
St. Albans, VT 05478
Phone
(802) 524-1223
Fax
(802) 524-1095
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 52047141205 UT
Occupational Medicine Physician 2083X0100X 162694-1 NY
General Practice Physician 208D00000X DR.0073557 CO
General Practice Physician 208D00000X 042.0013949 VT Primary

Addresses

Primary practice location

133 Faifield St.
St. Albans, VT 05478

Mailing address

133 Faifield St.
St. Albans, VT 05478
Phone (802) 524-1223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR, CO3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20221205002820 WA Practitioner - Other (Physician) 3678469731 Reassigns benefits to 1 organization
I20221207000442 OR Practitioner - Other (Physician) 3678469731 Reassigns benefits to 1 organization
I20240915000016 CO Practitioner - Emergency MedicinePractitioner - Preventive Medicine 3678469731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Preventive Medicine
Education
Saint Louis University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

550 Thornton Pkwy
Unit 110
Thornton, CO 80229-2166
Phone (720) 872-0399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52047141205UTMDEmergency Medicine Physician
162694-1NYMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA CurrentSince Aug 31, 2024 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Oct 17, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Emergency Medicine CurrentSince Oct 17, 2022 Accepting new patients
Emcare Physician Providers Inc Emergency Medicine Past Accepting new patients
Twin Valley Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Pocono Emergency Physicians, P.C. Emergency Medicine Past Accepting new patients

Locations

1730 Blake St
Ste 100
Denver, CO 80202
Phone (303) 296-2273

550 Thornton Pkwy
Unit 110
Thornton, CO 80229
Phone (303) 341-1799

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1508963596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 FAIFIELD ST.",
            "city": "ST. ALBANS",
            "state": "VT",
            "postal_code": "05478",
            "telephone_number": "802-524-1223",
            "fax_number": "802-524-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 FAIFIELD ST.",
            "city": "ST. ALBANS",
            "state": "VT",
            "postal_code": "05478",
            "telephone_number": "802-524-1223",
            "fax_number": "802-524-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROL",
        "first_name": "SUSAN",
        "middle_name": "BETTY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "52047141205",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "NY",
            "license": "162694-1",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CO",
            "license": "DR.0073557",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VT",
            "license": "042.0013949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Albans, VT

Sources for this page

Verify at the official NPI Registry.