Active NPI
Sharon L Hackett, M.D.
- Dermatology Physician
- Newport, VT
National Provider Identifier
1598842874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 0420010181
- Practice address
- 189 Prouty Dr
Newport, VT 05855-9326 - Phone
- (802) 334-4111
- Fax
- (802) 334-3281
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 0420010181 | VT | Primary |
Addresses
Primary practice location
189 Prouty Dr
Newport, VT 05855-9326
Mailing address
189 Prouty Dr
Newport, VT 05855-9326
Phone (802) 334-4111
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00058055 | Other | VT | BLUE SHIELD |
| 30201819 | Medicaid | NH | |
| 0VN2542 | Medicaid | VT | |
| 07784 | Other | VT | MVP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0420010181 | VT | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598842874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "189 PROUTY DR",
"city": "NEWPORT",
"state": "VT",
"postal_code": "058559326",
"telephone_number": "802-334-4111",
"fax_number": "802-334-3281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "189 PROUTY DR",
"city": "NEWPORT",
"state": "VT",
"postal_code": "058559326",
"telephone_number": "802-334-4111",
"fax_number": "802-334-3281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKETT",
"first_name": "SHARON",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "VT",
"license": "0420010181",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00058055",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30201819",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0VN2542",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "07784",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Newport, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.