Judith Ellwood, MS, APRN

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

1010013650 Issued in VT

Practice address

275 Route 30 N
Bomoseen, VT 05732-9647

Phone

(802) 468-5641

Fax

(802) 468-2923

NPI assigned

May 19, 2006

Last updated

Jul 22, 2016By the provider in NPPES

Sex

Female

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 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Centers of the Rutland Region Inc

  dba Rutland Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Rutland, VT
  • NPI 1467681114
  Medicare reassignment NPD
• Community Health Centers of the Rutland Region, Inc.

  • Family Medicine Physician
  • Brandon, VT
  • NPI 1073567590
  Medicare reassignment NPD
• Community Health Centers of the Rutland Region, Inc.

  dba dba Mettowee Valley Family Health Center

  • Family Medicine Physician
  • West Pawlet, VT
  • NPI 1104870922
  Medicare reassignment NPD
• Community Health Centers of the Rutland Region, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bomoseen, VT
  • NPI 1336193838
  Medicare reassignment NPD
• Community Health Centers of the Rutland Region, Inc.

  dba CHCRR Pediatrics

  • Pediatrics Physician
  • Rutland, VT
  • NPI 1780969345
  Medicare reassignment NPD
• Community Health Centers of the Rutland Region Inc

  dba Community Health North Main St

  • Federally Qualified Health Center (FQHC)
  • Rutland, VT
  • NPI 1518613215
  NPD
• Community Health Centers of the Rutland Region, Inc

  dba Shorewell Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Shoreham, VT
  • NPI 1811241094
  NPD
• Bristol Internal Medicine, PC

  • Internal Medicine Physician
  • Bristol, VT
  • NPI 1235182247
  NPD (past)
• Elderly Services, Inc.

  • Voluntary or Charitable Agency
  • Middlebury, VT
  • NPI 1871557108
  NPD (past)
• Porter Hospital Inc

  dba Porter Hospital Inc dba Neshobe Family Medicine

  • Family Medicine Physician
  • Brandon, VT
  • NPI 1609896935
  NPD (past)
• Porter Hospital, Inc

  dba Porter Medical Group

  • Family Medicine Physician
  • Middlebury, VT
  • NPI 1134457013
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1699728436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 ALLEN ST",
            "address_2": "STE 403",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014570",
            "telephone_number": "802-772-4414",
            "fax_number": "802-772-7973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 ROUTE 30 N",
            "city": "BOMOSEEN",
            "state": "VT",
            "postal_code": "057329647",
            "telephone_number": "802-468-5641",
            "fax_number": "802-468-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLWOOD",
        "first_name": "JUDITH",
        "credential": "MS, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "VT",
            "license": "1010013650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02780087",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012833",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community Health Centers of the Rutland Region, Inc.
• Tammy Ann Delbianco, RPH.
• Hans Peter Diercksen, MD
• Maria Grace Durkee, MS, RDN, CD
• Sarah Hart Dwyer, APRN
• Julie A Foster, MD
• Megan I. Greenleaf, M.D.
• Jennifer Day Hanson, MD
• Harbor Pharmacy
• Theresa Haywood, N.P.

• Women's Health Nurse Practitioner in Bomoseen, VT
• Providers in Bomoseen, VT by specialty
• Women's Health Nurse Practitioner in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.