Owen W Drudge, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

048-0000672 Issued in VT

Practice address

790 College Pkwy
Colchester, VT 05446-3007

Phone

(802) 847-4378

Fax

(802) 847-8899

NPI assigned

Jul 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669486080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 COLLEGE PKWY",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054463007",
            "telephone_number": "802-847-4378",
            "fax_number": "802-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 COLLEGE PKWY",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054463007",
            "telephone_number": "802-847-4378",
            "fax_number": "802-847-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUDGE",
        "first_name": "OWEN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "VT",
            "license": "048-0000672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN1456",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Leigh Donovan, PHARMD
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• Thomas Peter Drougas, RPH
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• John M Dupont, COTA
• Christine Sandra Dutil, RPH
• Robert Martin Duwors, PHD
• Paula Griffin Dwan, N.P.

• Clinical Neuropsychologist in Colchester, VT
• Providers in Colchester, VT by specialty
• Clinical Neuropsychologist 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.