Jennifer Mary Fauntleroy, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

042-0009568 Issued in VT

Practice address

11 Court SQ
Rutland, VT 05701-4030

Phone

(802) 775-1398

Fax

(802) 775-5196

NPI assigned

Feb 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Psychiatry

Education

New York University School of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Jennifer Fauntleroy, M.D., P.C.

  • Psychiatry Physician
  • Rutland, VT
  • NPI 1669498853
  Medicare reassignment NPD Authorized official
• Rutland Hospital, Inc.

  • Psychiatric Hospital Unit
  • Rutland, VT
  • NPI 1467416206
  Medicare reassignment NPD
• Rutland Mental Health Services, Inc.

  • Community/Behavioral Health Agency
  • Rutland, VT
  • NPI 1245127620
  NPD (past)

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669448981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 COURT SQ",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014030",
            "telephone_number": "802-775-1398",
            "fax_number": "802-775-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 COURT SQ",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014030",
            "telephone_number": "802-775-1398",
            "fax_number": "802-775-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUNTLEROY",
        "first_name": "JENNIFER",
        "middle_name": "MARY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042-0009568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN1669",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Rutland, VT
• Providers in Rutland, VT by specialty
• Psychiatry Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.