Individual provider Active NPI

Molly Andersen, NP

  • Pediatric Nurse Practitioner
  • Woodstock, VT
National Provider Identifier
1750877403
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F382852-1 Issued in NY
Practice address
32 Pleasant St
Woodstock, VT 05091-1122
Phone
(802) 457-3030
NPI assigned
Jul 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X F382852-1 NY Primary

Addresses

Primary practice location

32 Pleasant St
Woodstock, VT 05091-1122

Mailing address

32 Pleasant St
Woodstock, VT 05091-1122
Phone (802) 457-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181011002665 NY Practitioner - Nurse Practitioner 9032461470
I20211122001524 VT Practitioner - Nurse Practitioner 9032461470 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F382852-1NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Windsor Hospital Corporation CurrentSince Nov 10, 2021 Accepting new patients
Windsor Hospital Corporation CurrentSince Nov 10, 2021 Accepting new patients
Windsor Hospital Corporation Current Accepting new patients

Locations

289 County Rd
Windsor, VT 05089
Phone (802) 674-7220

32 Pleasant St
Woodstock, VT 05091
Phone (802) 457-3030

Interoperability endpoints

  • Direct secure messaging: mandersen622857@direct.dartmouth-hitchcock.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1750877403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 PLEASANT ST",
            "city": "WOODSTOCK",
            "state": "VT",
            "postal_code": "050911122",
            "telephone_number": "802-457-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 PLEASANT ST",
            "city": "WOODSTOCK",
            "state": "VT",
            "postal_code": "050911122",
            "telephone_number": "802-457-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "MOLLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382852-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, VT

Sources for this page

Verify at the official NPI Registry.