William T Gerson, M.D.

Individual provider Active NPI Pediatrics Physician · South Burlington, VT

NPI 1528072212 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1528072212
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
0420007748 (VT)
Practice address
52 Timberlane
South Burlington, VT 05403-7296
Phone
(802) 658-2320
Fax
(802) 863-6933
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0420007748VTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Past Accepting new patients
Pediatric Medicine, PLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHGFCA/Endpoint/IHGFCA

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0420007748 VT Yes

Addresses

Primary practice location

52 Timberlane
South Burlington, VT 05403-7296

Mailing address

52 Timberlane
South Burlington, VT 05403-7296
Phone (802) 658-2320

Other identifiers

IdentifierTypeStateIssuer
1002259MedicaidVT
2487OtherVTBLUE CROSS BLUE SHIELD
26V020OtherVTMVP

Other providers in South Burlington, VT

All providers in South Burlington, VT · Pediatrics Physician in Vermont

Sources for this page

Verify at the official NPI Registry.