Marble Valley Healthworks, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MARBLE VALLEY HEALTHWORKS, LLC

Practice address

8 Commons St
Rutland, VT 05701-4651

Phone

(802) 772-1989

Fax

(802) 773-4876

NPI assigned

Jan 25, 2018

Last updated

Jun 20, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ann M Hughes

Title

Practice Manager

Phone

(802) 772-1989

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/zA015PZlU6y4mS2M66rhwFskWFFyp2EA/

Practitioners 4

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.

• Bruce D Bullock, MD

  • Family Medicine Physician
  • Rutland, VT
  • NPI 1649250358
  Medicare reassignment Care Compare group NPD
• Seth G Coombs, MD

  • Internal Medicine Physician
  • Rutland, VT
  • NPI 1619955069
  Medicare reassignment Care Compare group NPD
• Sally J Beayon, FNP-C

  • Family Medicine Physician
  • Bomoseen, VT
  • NPI 1124672340
  Medicare reassignment NPD
• Suzanne Jones, PA.C

  • Physician Assistant
  • Rutland, VT
  • NPI 1457482101
  Medicare reassignment

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560988800000",
    "number": "1801394895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 COMMONS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014651",
            "telephone_number": "802-772-1989",
            "fax_number": "802-773-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 COMMONS ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014651",
            "telephone_number": "802-772-1989",
            "fax_number": "802-773-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARBLE VALLEY HEALTHWORKS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-25",
        "last_updated": "2019-06-20",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "802-772-1989"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "900026",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN0388",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN1341",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael John Mainolfi, PT
• Lisa Ann Major, PA-C
• Barbara Chamberlin Mallen, M.S., CCC-SLP
• Fredda E Mangel, MA
• Maple Tree General Surgery
• Marc a. Cecil, PH.D., P.C.
• Claudia Marceau, DMD
• Mark C. Stickney, MD, LLC
• Mark E Logan MD PC (Green Mountain Family Medicine)
• Shirley Markland, LICSW

• Family Medicine Physician in Rutland, VT
• Providers in Rutland, VT by specialty
• Family Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.