Organization Active NPI

Center for Integrative Medicine

  • Specialist
  • Rutland, VT
National Provider Identifier
1609079763
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CENTER FOR INTEGRATIVE MEDICINE
Practice address
69 Allen St
Suite 9
Rutland, VT 05701-4564
Phone
(802) 747-7730
Fax
(802) 773-1609
NPI assigned
Jun 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mark J. Bucksbaum, M.D.NPI 1215997697
Title
Owner
Phone
(802) 747-7730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

69 Allen St
Suite 9
Rutland, VT 05701-4564

Mailing address

69 Allen St
Suite 9
Rutland, VT 05701-4564
Phone (802) 747-7730

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609079763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 ALLEN ST",
            "address_2": "SUITE 9",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014564",
            "telephone_number": "802-747-7730",
            "fax_number": "802-773-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 ALLEN ST",
            "address_2": "SUITE 9",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014564",
            "telephone_number": "802-747-7730",
            "fax_number": "802-773-1609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INTEGRATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUCKSBAUM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-747-7730",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.