Individual provider Active NPI

Peter J Foote, DO

  • Family Medicine Physician
  • Brattleboro, VT
National Provider Identifier
1669404422
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0320069794 Issued in VT
Practice address
21 Belmont Ave
Suite 2
Brattleboro, VT 05301-7110
Phone
(802) 257-7792
Fax
(802) 254-7001
NPI assigned
Jul 6, 2006
Last updated
Nov 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB07656100 NJ
Family Medicine Physician 207Q00000X 0320069794 VT Primary

Addresses

Primary practice location

21 Belmont Ave
Suite 2
Brattleboro, VT 05301-7110

Mailing address

21 Belmont Ave
Suite 2
Brattleboro, VT 05301-7110
Phone (802) 257-7792

Other identifiers 1

IdentifierTypeStateIssuer
1018240MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20151123001648 NC Order and Referring Only - Family PracticePractitioner - Family Practice 8628091725

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0320069794VTMDFamily Medicine Physician
00083NCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hunterdon Medical Center Family Medicine Past Accepting new patients
Southern Vermont Health Services Corp Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289347200000",
    "number": "1669404422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BELMONT AVE",
            "address_2": "SUITE 2",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053017110",
            "telephone_number": "802-257-7792",
            "fax_number": "802-254-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BELMONT AVE",
            "address_2": "SUITE 2",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053017110",
            "telephone_number": "802-257-7792",
            "fax_number": "802-254-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOTE",
        "first_name": "PETER",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2010-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB07656100",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "0320069794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018240",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.