NPIMap

Organization Active NPI

Northwestern Medical Center, Inc.

  • Nutrition Education Nutritionist
  • Saint Albans, VT
National Provider Identifier
1699809533
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
Legal business name
NORTHWESTERN MEDICAL CENTER, INC.
Doing business as
Northwestern Lifestyle Medicine
Practice address
260 Crest Rd
Suite 202
Saint Albans, VT 05478-9503
Phone
(802) 524-1227
Fax
(802) 524-8498
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Authorized official

Name
Mrs. Mary Pigeon
Title
Credentialing Specialist
Phone
(802) 524-8954

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133NN1002X Primary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Registered Dietetic TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 136A00000X

Addresses

Primary practice location

260 Crest Rd
Suite 202
Saint Albans, VT 05478-9503

Mailing address

133 Fairfield St
Saint Albans, VT 05478-1726
Phone (802) 524-1227

Other identifiers 1

IdentifierTypeStateIssuer
0024685OtherVTGROUP PTAN

Other names 1

  • Northwestern Lifestyle Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northwestern Medical Center36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1699809533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 FAIRFIELD ST",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054781726",
            "telephone_number": "802-524-1227",
            "fax_number": "802-524-8498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 CREST RD",
            "address_2": "SUITE 202",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054789503",
            "telephone_number": "802-524-1227",
            "fax_number": "802-524-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "PIGEON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "802-524-8954",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "136A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietetic Technician, Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "0024685",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwestern Lifestyle Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Albans, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.