Individual provider Active NPI

Cheryl Underwood, FNP

  • Family Nurse Practitioner
  • Williston, VT
National Provider Identifier
1669979068
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
101.0134237 Issued in VT
Practice address
28 Park Ave
Williston, VT 05495-9701
Phone
(802) 878-1008
Fax
(802) 872-2679
NPI assigned
Apr 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 026.0027479 VT
Family Nurse Practitioner 363LF0000X 101.0134237 VT Primary

Addresses

Primary practice location

28 Park Ave
Williston, VT 05495-9701

Mailing address

363 Carpenter Hill Rd
Saint Albans, VT 05478-6096
Phone (802) 345-8161

Other practice location 1

300 Pearl St
Burlington, VT 05401-8531
Phone (802) 658-4200

Other identifiers 1

IdentifierTypeStateIssuer
14413831MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, CT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190315000200 VT Practitioner - Nurse Practitioner 6709126485 Reassigns benefits to 1 organization
I20200410000709 CT Practitioner - Nurse Practitioner 6709126485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Evergreen Family Health PartnersGroup PAC ID 1153402888, 20 clinicians

Practice addresses (Care Compare)

426 Industrial Ave
Suite 130
Williston, VT 05495-4449
Phone (802) 878-1008

8 Essex Way
201 Dba Alderbrook Family Health
Essex Junction, VT 05452-3422
Phone (802) 872-7100

Hospital & facility affiliations

  • Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
026.0027479VTMDEmergency Registered Nurse
101.0134237VTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Family Health Partners CurrentSince Oct 1, 2020 Accepting new patients
Alder Brook Family Health P.C. PastSince Feb 8, 2015 Accepting new patients

Locations

8 Essex Way
Ste 201
Essex Junction, VT 05452
Phone (802) 872-7100

426 Industrial Ave
Ste 130
Williston, VT 05495
Phone (518) 593-7466

28 Park Ave
Williston, VT 05495
Phone (802) 878-1008

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1669979068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 CARPENTER HILL RD",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054786096",
            "telephone_number": "802-345-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 PARK AVE",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054959701",
            "telephone_number": "802-878-1008",
            "fax_number": "802-872-2679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Pearl St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054018531",
            "country_code": "US",
            "telephone_number": "802-658-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "CHERYL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "VT",
            "license": "026.0027479",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101.0134237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14413831",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, VT

Sources for this page

Verify at the official NPI Registry.