Individual provider Active NPI

Elisabeth Kirsten Wegner, M.D.

  • Obstetrics & Gynecology Physician
  • Burlington, VT
National Provider Identifier
1619995685
Registry record updated Oct 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
042-0009221 Issued in VT
Practice address
111 Colchester Ave
Fahc, Acc MP4
Burlington, VT 05401-1473
Phone
(802) 847-1400
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 042-0009221 VT Primary
Gynecology Physician 207VG0400X 042-0009221 VT
Obstetrics Physician 207VX0000X 042-0009221 VT

Addresses

Primary practice location

111 Colchester Ave
Fahc, Acc MP4
Burlington, VT 05401-1473

Mailing address

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-1400

Other identifiers 2

IdentifierTypeStateIssuer
0VN1330MedicaidVT
01647667OtherNYNY MEDICAID

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060404000493 VT Practitioner - Obstetrics/Gynecology 6800804782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Connecticut School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 S Prospect St
Burlington, VT 05401-3456
Phone (802) 847-0000

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0009221VTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Obstetrics & Gynecology CurrentSince Aug 1, 1996 Accepting new patients
Porter Hospital, Inc Obstetrics & Gynecology CurrentSince May 19, 2025 Accepting new patients
University of Vermont Medical Center Inc Past Accepting new patients

Locations

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

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

111 Colchester Ave
#4
Burlington, VT 05401
Phone (802) 847-0552

104 Porter Dr
Middlebury, VT 05753
Phone (802) 388-5682

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

82 Catamount Park
Middlebury, VT 05753
Phone (802) 388-7185

Interoperability endpoints

  • Direct secure messaging: ewegner3839@direct.uvmhealth.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380844800000",
    "number": "1619995685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "FAHC, ACC MP4",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEGNER",
        "first_name": "ELISABETH",
        "middle_name": "KIRSTEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2013-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VT",
            "license": "042-0009221",
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "VT",
            "license": "042-0009221",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "VT",
            "license": "042-0009221",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN1330",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY MEDICAID",
            "identifier": "01647667",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.