Theresa Haywood, N.P.
Individual provider Active NPI Family Nurse Practitioner · Bomoseen, VT
NPI 1891196804 · NPPES record last updated Dec 13, 2021
Key facts
- NPI
- 1891196804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 101.0103560 (VT)
- Practice address
- 275 Route 30 N
Bomoseen, VT 05732-9647 - Phone
- (802) 468-5641
- Fax
- (802) 468-2923
- NPI assigned
- Sep 9, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Community Health Centers of the Rutland Region Inc
Practice addresses (Care Compare)
231 N Main St
Rutland, VT 05701-2412
Phone (800) 468-9118
Hospital & facility affiliations
- Rutland Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141029000429 | VT | Practitioner - Nurse Practitioner | 6507087905 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101.0103560 | VT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Centers of the Rutland Region, Inc. | Current |
Accepting new patients | |
| Community Health Centers of the Rutland Region Inc | Current | Accepting new patients | |
| Community Health Centers of the Rutland Region, Inc. | Current |
Accepting new patients | |
| Community Health Centers of the Rutland Region, Inc. | Current |
Accepting new patients | |
| Community Health Centers of the Rutland Region, Inc. | Current |
Accepting new patients | |
| Community Health Centers of the Rutland Region Inc | Current |
Accepting new patients | |
| Community Health Centers of the Rutland Region, Inc. | Current |
Accepting new patients |
Locations
275 VT 30 N
Bomoseen, VT 05732
Phone (802) 468-5641
420 Grove St
Brandon, VT 05733
Phone (802) 247-6305
1 General Wing Rd
Rutland, VT 05701
Phone (802) 773-9131
71 Allen St
Ste 403
Rutland, VT 05701
Phone (802) 772-4414
71 Allen St
Ste 402
Rutland, VT 05701
Phone (800) 468-9118
2987 Vt Route 22A
Shoreham, VT 05770
Phone (802) 897-7000
278 Vt Route 149
West Pawlet, VT 05775
Phone (800) 468-9118
Interoperability endpoints
- thaywood@chcrr.medentdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 101.0103560 | VT | |
| Family Nurse Practitioner | 363LF0000X | 101.0103560 | VT | Yes |
Addresses
Primary practice location
275 Route 30 N
Bomoseen, VT 05732-9647
Mailing address
71 Allen St
Ste 403
Rutland, VT 05701-4570
Phone (802) 772-4414
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023840 | Medicaid | VT |
Other providers in Bomoseen, VT
- Judith Ellwood
- Julie A Foster
- Megan I. Greenleaf
- Jennifer Day Hanson
- Harbor Pharmacy
- Andrea R Hubbard Maclauchlan
- Jayme Hughes
- JMS Pharmacy Management Inc
- Erin Joiner
- Pauline Kahng
All providers in Bomoseen, VT · Family Nurse Practitioner in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.