NPIMap

Northeastern Vermont Regional Hospital Dietary Clinic

Organization Active NPI Critical Access Hospital · St Johnsbury, VT

NPI 1720021181 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1720021181
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
License
673 (VT)
Legal business name
NORTHEASTERN VERMONT REGIONAL HOSPITAL DIETARY CLINIC
Practice address
1315 Hospital Dr
St Johnsbury, VT 05819-9210
Phone
(802) 748-8141
Fax
(802) 748-4098
NPI assigned
Jun 14, 2006
Organization subpart
No

Authorized official

Name
Robert N Hersey
Title
Cfo
Phone
(802) 748-8141

Corporate family (same tax ID) 12

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

National Provider Directory

Tax ID family
Dba NVRH ER Physician G (13 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 673 VT Yes

Addresses

Primary practice location

1315 Hospital Dr
St Johnsbury, VT 05819-9210

Mailing address

1315 Hospital Dr
St Johnsbury, VT 05819-9210
Phone (802) 748-8141

Other identifiers

IdentifierTypeStateIssuer
00069029OtherVTBLUECROSS BLUESHIELD VT

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720021181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 HOSPITAL DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199210",
            "telephone_number": "802-748-8141",
            "fax_number": "802-748-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 HOSPITAL DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199210",
            "telephone_number": "802-748-8141",
            "fax_number": "802-748-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN VERMONT REGIONAL HOSPITAL DIETARY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERSEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "802-748-8141"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "VT",
            "license": "673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD VT",
            "identifier": "00069029",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johnsbury, VT

All providers in St Johnsbury, VT · Critical Access Hospital in Vermont

Sources for this page

Verify at the official NPI Registry.