Individual provider Active NPI

James M Tallmadge, PH.D.

  • Clinical Psychologist
  • Burlington, VT
National Provider Identifier
1578577508
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
048-0000475 Issued in VT
Practice address
1 S Prospect St
Arnold 3
Burlington, VT 05401-3456
Phone
(802) 847-4560
Fax
(802) 847-8747
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 048-0000475 VT
Clinical Psychologist 103TC0700X 048-0000475 VT Primary
Clinical Child & Adolescent Psychologist 103TC2200X 048-0000475 VT

Addresses

Primary practice location

1 S Prospect St
Arnold 3
Burlington, VT 05401-3456

Mailing address

19 Barbara Ter
Colchester, VT 05446-6623
Phone (802) 658-6321

Other identifiers 1

IdentifierTypeStateIssuer
0009602MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060826000037 VT Practitioner - Clinical Psychologist 7810991239 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
048-0000475VTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc CurrentSince May 3, 2010 Accepting new patients
Clarity Laboratories, Inc. Clinical Past Accepting new patients

Locations

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

1 S Prospect St
#3
Burlington, VT 05401
Phone (802) 847-4563

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339632000000",
    "number": "1578577508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BARBARA TER",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054466623",
            "telephone_number": "802-658-6321",
            "fax_number": "888-908-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S PROSPECT ST",
            "address_2": "ARNOLD 3",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013456",
            "telephone_number": "802-847-4560",
            "fax_number": "802-847-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLMADGE",
        "first_name": "JAMES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "VT",
            "license": "048-0000475",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "048-0000475",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VT",
            "license": "048-0000475",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009602",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.