Maple Tree General Surgery

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

042-0010388 Issued in VT

Legal business name

MAPLE TREE GENERAL SURGERY

Practice address

215 Stratton Rd
Rutland, VT 05701-4621

Phone

(802) 775-7745

Fax

(802) 775-5155

NPI assigned

Sep 20, 2006

Last updated

Aug 22, 2020By 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

Brad Lee Jimmo, MDNPI 1437184637

Title

Surgeon

Phone

(802) 775-7745

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Brad Lee Jimmo, M.D.

  • Surgery Physician
  • Rutland, VT
  • NPI 1437184637
  Authorized official Same address or phone

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871690099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 STRATTON RD",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014621",
            "telephone_number": "802-775-7745",
            "fax_number": "802-775-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 STRATTON RD",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014621",
            "telephone_number": "802-775-7745",
            "fax_number": "802-775-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE TREE GENERAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JIMMO",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "SURGEON",
        "authorized_official_telephone_number": "802-775-7745",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VT",
            "license": "042-0010388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Joseph Mahoney, DNP, APRN
• Michael John Mainolfi, PT
• Lisa Ann Major, PA-C
• Barbara Chamberlin Mallen, M.S., CCC-SLP
• Fredda E Mangel, MA
• Marble Valley Healthworks, LLC
• Marc a. Cecil, PH.D., P.C.
• Claudia Marceau, DMD
• Mark C. Stickney, MD, LLC
• Mark E Logan MD PC (Green Mountain Family Medicine)

• Surgery Physician in Rutland, VT
• Providers in Rutland, VT by specialty
• Surgery Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.