NPIMap

Organization Active NPI

Health Care and Rehabilitation Services of Southeastern Vermont, Inc.

  • Community/Behavioral Health Agency
  • Springfield, VT
National Provider Identifier
1790861342
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
HEALTH CARE AND REHABILITATION SERVICES OF SOUTHEASTERN VERMONT, INC.
Practice address
390 River St
Springfield, VT 05156-2226
Phone
(802) 886-4500
Fax
(802) 886-4520
NPI assigned
Oct 27, 2006
Last updated
Apr 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Authorized official

Name
Edmund H. Moore IV
Title
Chief Financial Officer
Phone
(802) 886-4567

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Case Management Agency 251B00000X VT
Community/Behavioral Health Agency 251S00000X NU
Community/Behavioral Health Agency 251S00000X VT Primary

Addresses

Primary practice location

390 River St
Springfield, VT 05156-2226

Mailing address

390 River St
Springfield, VT 05156-2226
Phone (802) 886-4500

Other identifiers 1

IdentifierTypeStateIssuer
0006166MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040819001433 VT Part B Supplier - Clinic/Group Practice 4183698830 Receives reassigned benefits from 39 practitioners
5 other NPIs on this enrollment
Practice locations: Bellows Falls, VT; Brattleboro, VT; Hartford, VT; Newfane, VT; Springfield, VT; White River Junction, VT; Windsor, VT

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

51 Fairview St
Brattleboro, VT 05301
Phone (802) 254-6028

Practitioners & affiliated clinicians

Practitioners 142

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.

View all 142

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554163200000",
    "number": "1790861342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 RIVER ST",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051562226",
            "telephone_number": "802-886-4500",
            "fax_number": "802-886-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 RIVER ST",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051562226",
            "telephone_number": "802-886-4500",
            "fax_number": "802-886-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CARE AND REHABILITATION SERVICES OF SOUTHEASTERN VERMONT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2019-04-02",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "EDMUND",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "802-886-4567",
        "authorized_official_name_suffix": "IV"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "VT",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006166",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.