Individual provider Active NPI

John M Ajamie, MD

  • Family Medicine Physician
  • St Johnsbury, VT
National Provider Identifier
1689637399
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042-0007191 Issued in VT
Practice address
1315 Hospital Dr
Northeastern VT Regional Hospital
St Johnsbury, VT 05819-9210
Phone
(802) 748-8141
Fax
(802) 748-7541
NPI assigned
Apr 11, 2006
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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 0420007191 VT
Family Medicine Physician 207Q00000X 042-0007191 VT Primary

Addresses

Primary practice location

1315 Hospital Dr
Northeastern VT Regional Hospital
St Johnsbury, VT 05819-9210

Mailing address

PO Box 905
Northeastern VT Regional Hospital
St Johnsbury, VT 05819-0905
Phone (802) 748-8141

Other practice location 1

790 College Pkwy
Colchester, VT 05446-3007
Phone (802) 847-1170

Other identifiers 2

IdentifierTypeStateIssuer
0005157MedicaidVT
3086244MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0007191VTMDFamily Medicine Physician
0420007191VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital, Inc Current Accepting new patients
Northeastern Vermont Regional Hospital Inc Current Accepting new patients
Northern Counties Health Care, Inc. PastSince Sep 6, 2020 Accepting new patients
Northern Counties Health Care, Inc. Past Accepting new patients

Locations

1315 Hospital Dr
St Johnsbury, VT 05819
Phone (802) 748-3638

Organizations & group practices 6

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1689637399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 905",
            "address_2": "NORTHEASTERN VT REGIONAL HOSPITAL",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058190905",
            "telephone_number": "802-748-8141",
            "fax_number": "802-748-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 HOSPITAL DR",
            "address_2": "NORTHEASTERN VT REGIONAL HOSPITAL",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199210",
            "telephone_number": "802-748-8141",
            "fax_number": "802-748-7541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 College Pkwy",
            "address_purpose": "LOCATION",
            "city": "Colchester",
            "state": "VT",
            "postal_code": "054463007",
            "country_code": "US",
            "telephone_number": "802-847-1170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AJAMIE",
        "first_name": "JOHN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "0420007191",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042-0007191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005157",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3086244",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johnsbury, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.