Active NPI
James M Tallmadge, PH.D.
- Clinical Psychologist
- Burlington, VT
National Provider Identifier
1578577508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 048-0000475
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009602 | Medicaid | VT |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048-0000475 | VT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Vermont Medical Center Inc | Current | 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.
-
dba Uvm Medical Center
- Internal Medicine Physician
- Burlington, VT
- NPI 1659309615
-
- Clinical Psychologist
- Colchester, VT
- NPI 1770832750
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.