Individual provider Active NPI

Deborah Jerard, MD

  • Pediatrics Physician
  • Berlin, VT
National Provider Identifier
1649291360
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
042-0007761 Issued in VT
Practice address
246 Granger Rd
Suite 1
Berlin, VT 05602-0000
Phone
(802) 476-9242
Fax
(802) 225-5760
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 042-0007761 VT Primary

Addresses

Primary practice location

246 Granger Rd
Suite 1
Berlin, VT 05602-0000

Mailing address

PO Box 547
Central Vermont Medical Center - Finance Dept
Barre, VT 05641-0547
Phone (802) 476-9242

Other identifiers 1

IdentifierTypeStateIssuer
1002260MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, TX, SD3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20130923000046 VT Practitioner - Pediatric Medicine 5890939482 Reassigns benefits to 1 organization
I20170103000227 TX Practitioner - Pediatric Medicine 5890939482 Reassigns benefits to 1 organization
I20190123002418 SD Practitioner - Pediatric Medicine 5890939482 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0007761VTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health Network CurrentSince Nov 26, 2018 Accepting new patients
Sanford Health Network CurrentSince Nov 26, 2018 Accepting new patients
Sanford Health Network Current Accepting new patients
Central Vermont Medical Center Inc Pediatrics CurrentSince Aug 19, 2013 Accepting new patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Oct 31, 2016 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Oct 31, 2016 Accepting new patients

Locations

3015 3rd Ave SE
Ste 120
Aberdeen, SD 57401
Phone (605) 725-1700

701 3rd Ave S
Clear Lake, SD 57226
Phone (605) 874-2141

246 Granger Rd
Ste 1
Barre, VT 05641
Phone (802) 371-5950

130 Fisher Rd
#C
Berlin, VT 05602
Phone (802) 225-5400

Interoperability endpoints

  • Direct secure messaging: djerard262248@direct.uvmhealth.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417651200000",
    "number": "1649291360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "address_2": "CENTRAL VERMONT MEDICAL CENTER - FINANCE DEPT",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-476-9242",
            "fax_number": "802-225-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 GRANGER RD",
            "address_2": "SUITE 1",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056020000",
            "telephone_number": "802-476-9242",
            "fax_number": "802-225-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERARD",
        "first_name": "DEBORAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VT",
            "license": "042-0007761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002260",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, VT

Sources for this page

Verify at the official NPI Registry.