Active NPI
Belle Traver McDougall, PA-C
- Physician Assistant
- South Burlington, VT
National Provider Identifier
1609829183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 055-0030428
- Practice address
- 192 Tilley Dr
South Burlington, VT 05403-4440 - Phone
- (802) 847-4914
- Fax
- (802) 847-7470
- NPI assigned
- May 18, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 055-0030428 | VT | Primary |
Addresses
Primary practice location
192 Tilley Dr
South Burlington, VT 05403-4440
Mailing address
192 Tilley Dr
South Burlington, VT 05403-4440
Phone (802) 847-4914
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000314 | Medicaid | VT | |
| 00019672 | Other | VT | BLUE CROSS |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055-0030428 | VT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417651200000",
"number": "1609829183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "192 TILLEY DR",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054034440",
"telephone_number": "802-847-4914",
"fax_number": "802-847-7470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "192 TILLEY DR",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054034440",
"telephone_number": "802-847-4914",
"fax_number": "802-847-7470"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDOUGALL",
"first_name": "BELLE",
"middle_name": "TRAVER",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2014-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VT",
"license": "055-0030428",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9000314",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "00019672",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.