NPIMap

Organization Active NPI

Northeastern Vermont Regional Hospital Inc

  • Physical Therapist
  • Lyndonville, VT
National Provider Identifier
1821565631
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
NORTHEASTERN VERMONT REGIONAL HOSPITAL INC
Practice address
569 Main St
Lyndonville, VT 05851-9240
Phone
(802) 626-4224
NPI assigned
Oct 30, 2018
Organization subpart
Yes
Parent organization
NORTHEASTERN VERMONT REGIONAL HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Authorized official

Name
Robert N Hersey
Title
Cfo
Phone
(802) 748-7520

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

569 Main St
Lyndonville, VT 05851-9240

Mailing address

PO Box 905
St Johnsbury, VT 05819-0905
Phone (802) 748-7976

Other identifiers 2

IdentifierTypeStateIssuer
1034706MedicaidVT
3119019MedicaidNH

Other names 1

  • NVRH Northern Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110607000721 VT Part B Supplier - Hospital Department(S) 3678481405 Receives reassigned benefits from 22 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lyndonville, VT; St Johnsbury, VT

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Dba NVRH ER Physician G13 organizations share this tax ID, including this one
Part of
Dba NVRH ER Physician G

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1821565631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 905",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058190905",
            "telephone_number": "802-748-7976",
            "fax_number": "802-748-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 MAIN ST",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058519240",
            "telephone_number": "802-626-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN VERMONT REGIONAL HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEASTERN VERMONT REGIONAL HOSPITAL INC",
        "enumeration_date": "2018-10-30",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "HERSEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "802-748-7520"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034706",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3119019",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NVRH Northern Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NVRH Northern Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lyndonville, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.