Individual provider Active NPI

John Merrill Severinghaus, M.D.

  • Internal Medicine Physician
  • Bradford, VT
National Provider Identifier
1891839403
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G36863 Issued in CA
Practice address
2122 Lower PLN
Merry Meadow Farm
Bradford, VT 05033-8936
Phone
(802) 222-4412
Fax
(802) 222-5422
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G36863 CA Primary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 7237 NH
Psychiatry Physician 2084P0800X 7237 NH
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X VT
Psychiatry Physician 2084P0800X VT

Addresses

Primary practice location

2122 Lower PLN
Merry Meadow Farm
Bradford, VT 05033-8936

Mailing address

PO Box 234
Norwich, VT 05055-0234
Phone (802) 649-1323

Other identifiers 1

IdentifierTypeStateIssuer
00009936MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G36863CAMDInternal Medicine Physician
7237NHMDPsychiatry Physician
420008270VTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Merry Meadow Farm Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1891839403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 234",
            "city": "NORWICH",
            "state": "VT",
            "postal_code": "050550234",
            "telephone_number": "802-649-1323",
            "fax_number": "802-649-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 LOWER PLN",
            "address_2": "MERRY MEADOW FARM",
            "city": "BRADFORD",
            "state": "VT",
            "postal_code": "050338936",
            "telephone_number": "802-222-4412",
            "fax_number": "802-222-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERINGHAUS",
        "first_name": "JOHN",
        "middle_name": "MERRILL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G36863",
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NH",
            "license": "7237",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NH",
            "license": "7237",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "VT",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00009936",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.