NPIMap

Organization Active NPI

Northwestern Medical Center, Inc.

  • Ophthalmology Physician
  • Saint Albans, VT
National Provider Identifier
1760748693
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
NORTHWESTERN MEDICAL CENTER, INC.
Doing business as
Northwestern Ophthalmology
Practice address
128 Fisher Pond Rd, 2ND Floor
Suite 3
Saint Albans, VT 05478-6058
Phone
(802) 752-1921
Fax
(802) 752-1356
NPI assigned
Apr 4, 2012
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
Mary E Pigeon
Title
Credentialing Specialist
Phone
(802) 524-8954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

128 Fisher Pond Rd, 2ND Floor
Suite 3
Saint Albans, VT 05478-6058

Mailing address

128 Fisher Pond Road, 2ND Floor
Suite 3
Saint Albans, VT 05478-4405
Phone (802) 752-1921

Other identifiers 1

IdentifierTypeStateIssuer
1020384MedicaidVT

Other names 1

  • Northwestern Ophthalmology 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

Locations

128 Fisher Pond Rd
#2
Saint Albans, VT 05478
Phone (802) 524-9707

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1760748693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 FISHER POND ROAD, 2ND FLOOR",
            "address_2": "SUITE 3",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054784405",
            "telephone_number": "802-752-1921",
            "fax_number": "802-752-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 FISHER POND RD, 2ND FLOOR",
            "address_2": "SUITE 3",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054786058",
            "telephone_number": "802-752-1921",
            "fax_number": "802-752-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-04",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "PIGEON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "802-524-8954"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020384",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwestern Ophthalmology",
            "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.