Individual provider Active NPI

Jeffery M Nowlan, ADAC

  • Addiction (Substance Use Disorder) Counselor
  • Burlington, VT
National Provider Identifier
1598066722
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
104278 Issued in VT
Practice address
31 Elmwood Ave
Burlington, VT 05401-4347
Phone
(802) 864-7423
Fax
(802) 660-0576
NPI assigned
Nov 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 104278 VT Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

31 Elmwood Ave
Burlington, VT 05401-4347

Mailing address

31 Elmwood Ave
Burlington, VT 05401-4347
Phone (802) 864-7423

Other identifiers 1

IdentifierTypeStateIssuer
12165201OtherVTCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170405001664 VT Practitioner - Clinical Social Worker 8921384934 Reassigns benefits to 1 organization
I20240216003322 VT Practitioner - Mental Health Counselor 8921384934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Vermont Medical Center IncGroup PAC ID 3779491071, 1,208 clinicians

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104278VTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc CurrentSince Jan 1, 2024 Accepting new patients
Gifford Medical Center Inc CurrentSince Mar 29, 2017 Accepting new patients
Gifford Medical Center Inc. CurrentSince Mar 29, 2017 Accepting new patients
Spectrum, Inc. Addiction (Substance Use Disorder) Past Accepting new patients

Locations

1823 Vt Rte 107
Bethel, VT 05032
Phone (802) 234-2114

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

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

44 S Main St
Randolph, VT 05060
Phone (802) 728-4441

Interoperability endpoints

  • Direct secure messaging: jnowlan199452@direct.uvmhealth.org

Organizations & group practices 4

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": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1598066722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 ELMWOOD AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014347",
            "telephone_number": "802-864-7423",
            "fax_number": "802-660-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 ELMWOOD AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014347",
            "telephone_number": "802-864-7423",
            "fax_number": "802-660-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWLAN",
        "first_name": "JEFFERY",
        "middle_name": "M",
        "credential": "ADAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "104278",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12165201",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.