NPIMap

Organization Active NPI

Gifford Medical Center

  • Respite Care
  • Randolph, VT
National Provider Identifier
1730365503
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
License
685 Issued in VT
Legal business name
GIFFORD MEDICAL CENTER
Practice address
44 S Main St
Randolph, VT 05060-1381
Phone
(802) 728-2372
Fax
(802) 728-2613
NPI assigned
Jan 11, 2008
Last updated
Jul 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Michael K Costa
Title
Ceo
Phone
(802) 728-2211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X 685 VT Primary

Addresses

Primary practice location

44 S Main St
Randolph, VT 05060-1381

Mailing address

44 S Main St
Randolph, VT 05060-1381
Phone (802) 728-2372

Other identifiers 1

IdentifierTypeStateIssuer
047R021MedicaidVT

Other names 1

  • Respite Other name

National Provider Directory

National Provider Directory
Tax ID family
Gifford Pediatric Inter6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1730365503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 S MAIN ST",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050601381",
            "telephone_number": "802-728-2372",
            "fax_number": "802-728-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 S MAIN ST",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050601381",
            "telephone_number": "802-728-2372",
            "fax_number": "802-728-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIFFORD MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "COSTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "802-728-2211"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "VT",
            "license": "685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047R021",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Respite",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Respite",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Randolph, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; 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.