Springfield Medical Care Systems Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Londonderry, VT
NPI 1639544331 · NPPES record last updated Oct 31, 2024
Key facts
- NPI
- 1639544331
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- SPRINGFIELD MEDICAL CARE SYSTEMS INC
- Practice address
- 38 Vermont Route 11
Londonderry, VT 05148-9555 - Phone
- (802) 824-6901
- NPI assigned
- Dec 7, 2015
- Organization subpart
- No
Authorized official
- Name
- Andrew Majka
- Title
- Cfo
- Phone
- (802) 886-8950
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 5
Corporate family (same tax ID) 16
Practitioners 52
-
Jeffery Lynn Allyn, M.D.
-
Adam M Ameele, PSY.D.
-
Rachel Elaine Bruce, M.D.
-
Barbara J Dalton, MD
-
Gianina Farrugia, APRN
-
Joni J Foster, NP
-
Nancy Beth Granger, LICSW
-
April R Harmer, OD
-
William K Hoser, PA-C
-
Kristen Elizabeth Hurd, PSY.D.
-
Laura Kalinen Lober, APRN
-
Nicole Anna Montoya, APRN
-
Kathleen Mary Moriglioni, FNP-BC
-
Deborah Harrison O'Brien, MSW LICSW
-
Sean C O'Brien, PA
-
Merryl Emily Pauly, MSW, LICSW
-
Karen M Petruney, APRN
-
Jackie M Roy, NP
-
Aimee Louise Searles, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Federally qualified health center certification: CCN 471859
- Legal name
- SPRINGFIELD MEDICAL CARE SYSTEMS INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Feb 24, 2016
- Last certification
- Feb 24, 2016
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 12, 1982 in VT
- Enrollment address
- 38 Vermont Route 11
Londonderry, VT 51489555
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Stephen J Varone |
Corporate Director |
Jan 1, 2023 | 100% |
| Cheryl a Sanctuary |
Corporate Director |
Jan 1, 2023 | 100% |
| Susan P White |
Corporate Director |
Oct 26, 2021 | 100% |
| Andrew J Majka |
Corporate Officer |
Jan 1, 2023 | 100% |
| Kendra E Ingalls |
Corporate Director | Feb 8, 2019 | 100% |
| W-2 Managing Employee | Feb 8, 2019 | 100% | |
| Joshua R Dufresne |
Corporate Officer |
Dec 1, 2018 | 100% |
| W-2 Managing Employee |
Dec 1, 2018 | 100% | |
| Jennifer L Anderson |
Corporate Director |
Oct 26, 2021 | 100% |
| Anthony P Petrillo |
Corporate Director |
Dec 8, 2020 | 100% |
| Amanda M McLeod |
Corporate Director |
Oct 26, 2021 | 100% |
| Edmond H Moore |
Corporate Director |
Dec 28, 2020 | 100% |
| Kelly M Pajala |
Corporate Director |
Jan 1, 2023 | 100% |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Springfield Hospital Inc. |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | May 12, 1982 |
| Springfield Hospital Inc. |
Hospital | 5% Or Greater Indirect Ownership Interest (100%) | May 12, 1982 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160122001936 | VT | Part a Provider - Federally Qualified Health Center (FQHC) | 9133157043 | Practice locations: Londonderry, VT |
National Provider Directory
- Tax ID family
- Springfield Medical Care Systems Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
38 Vermont Route 11
Londonderry, VT 05148-9555
Mailing address
PO Box 710
Springfield, VT 05156-0710
Phone (802) 886-8950
Other providers in Londonderry, VT
- Karen M Petruney
- Dianna Beevers Scott
- Aimee Louise Searles
- Springfield Hospital Inc
- Springfield Medical Care Systems Inc
- Ronald Vallario
- Meghan Lynn Ward
- Anna White
- Jeston Brock Whitsell
All providers in Londonderry, VT · Federally Qualified Health Center (FQHC) in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.