Active NPI
Green Mountain Urgent Care LLC
- Urgent Care Clinic/Center
- North Adams, MA
National Provider Identifier
1902495484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- Legal business name
- GREEN MOUNTAIN URGENT CARE LLC
- Practice address
- 856 State Rd
North Adams, MA 01247-3027 - Phone
- (603) 526-4635
- NPI assigned
- Jan 11, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Marcus J Hampers, MD
- Title
- Managing Employee
- Phone
- (603) 526-4635
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Primary |
Addresses
Primary practice location
856 State Rd
North Adams, MA 01247-3027
Mailing address
74 Pleasant St Ste 204
New London, NH 03257-5881
Phone (603) 526-4635
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6708107 | Medicaid | VT | |
| 110175971A | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210415002821 | MA | Part B Supplier - Clinic/Group Practice | 0547678369 |
Receives reassigned benefits from 10 practitioners Practice locations: North Adams, MA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D2229555 | Green Mountain Urgent Care LLC | Certificate of waiver | Jul 12, 2027 |
National Provider Directory
National Provider DirectoryLocations
856 State Rd
North Adams, MA 01247
Phone (413) 727-8088
Practitioners & affiliated clinicians
Practitioners 10
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": "1610323200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1902495484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "74 PLEASANT ST STE 204",
"city": "NEW LONDON",
"state": "NH",
"postal_code": "032575881",
"telephone_number": "603-526-4635",
"fax_number": "603-526-2151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "856 STATE RD",
"city": "NORTH ADAMS",
"state": "MA",
"postal_code": "012473027",
"telephone_number": "603-526-4635"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREEN MOUNTAIN URGENT CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-01-11",
"last_updated": "2022-07-21",
"certification_date": "2022-07-21",
"status": "A",
"authorized_official_last_name": "HAMPERS",
"authorized_official_first_name": "MARCUS",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "MANAGING EMPLOYEE",
"authorized_official_telephone_number": "603-526-4635",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6708107",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110175971A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Adams, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.