NPIMap

Organization Active NPI

Northern Counties HLTH Care Inc

Doing business as Island Pond Health Center

  • Clinic Pharmacy
  • Island Pond, VT
National Provider Identifier
1730101312
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
Legal business name
NORTHERN COUNTIES HLTH CARE INC
Doing business as
Island Pond Health Center
Practice address
82 Maple Street
Island Pond, VT 05846-0425
Phone
(802) 723-4300
Fax
(802) 723-4544
NPI assigned
Jul 24, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jack Donnelly
Title
Dir of Operations
Phone
(802) 748-9405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X Primary

Addresses

Primary practice location

82 Maple Street
Island Pond, VT 05846-0425

Mailing address

PO Box 425
Island Pond, VT 05846-0425

Other identifiers 2

IdentifierTypeStateIssuer
4703270OtherOTHER ID NUMBER-COMMERCIAL NUMBER
0007175MedicaidVT

Other names 1

  • ISLAND POND HEALTH CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northern Counties Healt17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730101312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 425",
            "city": "ISLAND POND",
            "state": "VT",
            "postal_code": "058460425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 MAPLE STREET",
            "city": "ISLAND POND",
            "state": "VT",
            "postal_code": "058460425",
            "telephone_number": "802-723-4300",
            "fax_number": "802-723-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN COUNTIES HLTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DONNELLY",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "DIR OF OPERATIONS",
        "authorized_official_telephone_number": "802-748-9405"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4703270",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007175",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ISLAND POND HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Island Pond, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.