Jeffrey Erik Haddock, M.D,

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0420011189 Issued in VT

Practice address

586 Oak Hill Rd
Williston, VT 05495-7103

Phone

(802) 878-8131

Fax

(802) 879-6853

NPI assigned

Jul 14, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thomas Chittenden Health Center, PLC

  • Family Medicine Physician
  • Williston, VT
  • NPI 1811099229
  Medicare reassignment NPD

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1861418782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 SAWMILL RD",
            "city": "JERICHO",
            "state": "VT",
            "postal_code": "054653143",
            "telephone_number": "802-899-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 OAK HILL RD",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957103",
            "telephone_number": "802-878-8131",
            "fax_number": "802-879-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOCK",
        "first_name": "JEFFREY",
        "middle_name": "ERIK",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "0420011189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A88830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Grealis, DPT,MS, PT
• Green Mountain Women's Imaging
• Ellen B Grimes, RDH, ED.D
• Sharon Barlow Gutwin, PT
• Cheryl Denise Hackett, RPH
• Joseph Hoskin Haddock, MD
• Haig Physical Medicine PLC
• Hair Builders of Burlington Inc
• Delyn Hall
• Erin Kathleen Hall, M.D.

• Family Medicine Physician in Williston, VT
• Providers in Williston, 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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.