NPIMap

Individual provider Active NPI

Conner Soderquist

  • Family Medicine Physician
  • Middlebury, VT
National Provider Identifier
1629605647
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042.0016874 Issued in VT
Practice address
82 Catamount Park
Middlebury, VT 05753-1292
Phone
(802) 388-7185
Fax
(802) 388-3445
NPI assigned
Mar 27, 2020
Last updated
Dec 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 042.0016874 VT Primary

Addresses

Primary practice location

82 Catamount Park
Middlebury, VT 05753-1292

Mailing address

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

Other practice location 1

279 Lincoln St
Worcester, MA 01605-2120
Phone (508) 334-6109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240923002792 VT Practitioner - Family Practice 0840610655 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Vermont College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Evergreen Family Health PartnersGroup PAC ID 1153402888, 20 clinicians

Practice addresses (Care Compare)

426 Industrial Ave
Suite 130
Williston, VT 05495-4449
Phone (802) 878-1008

8 Essex Way
201 Dba Alderbrook Family Health
Essex Junction, VT 05452-3422
Phone (802) 872-7100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042.0016874VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Porter Hospital, Inc Family Medicine CurrentSince Dec 1, 2025 Accepting new patients
Evergreen Family Health Partners Family Medicine CurrentSince Jul 12, 2024 Accepting new patients
Alder Brook Family Health P.C. Family Medicine PastSince Feb 8, 2015 Accepting new patients

Locations

8 Essex Way
Ste 201
Essex Junction, VT 05452
Phone (802) 872-7100

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

28 Park Ave
Williston, VT 05495
Phone (802) 878-1008

426 Industrial Ave
Ste 130
Williston, VT 05495
Phone (518) 593-7466

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1629605647",
    "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": "802-847-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 CATAMOUNT PARK",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057531292",
            "telephone_number": "802-388-7185",
            "fax_number": "802-388-3445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "279 Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052120",
            "country_code": "US",
            "telephone_number": "508-334-6109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SODERQUIST",
        "first_name": "CONNER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042.0016874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, VT

Sources for this page

Verify at the official NPI Registry.