Active NPI
Naomi K Fukagawa, M.D., PH.D.
- Pediatrics Physician
- Burlington, VT
National Provider Identifier
1790842110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 48073
- Practice address
- University of Vermont
89 Beaumont Avenue, Given Building C-207
Burlington, VT 05405-0001 - Phone
- (802) 656-4403
- NPI assigned
- Jan 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 48073 | MA | Primary |
Addresses
Primary practice location
University of Vermont
89 Beaumont Avenue, Given Building C-207
Burlington, VT 05405-0001
Mailing address
1061 Pheasant Hill Rd
Shelburne, VT 05482-7745
Phone (802) 985-5495
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48073 | MA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251417600000",
"number": "1790842110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1061 PHEASANT HILL RD",
"city": "SHELBURNE",
"state": "VT",
"postal_code": "054827745",
"telephone_number": "802-985-5495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UNIVERSITY OF VERMONT",
"address_2": "89 BEAUMONT AVENUE, GIVEN BUILDING C-207",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054050001",
"telephone_number": "802-656-4403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUKAGAWA",
"first_name": "NAOMI",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2009-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "48073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.