Loretta B. Charles, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

101.00113985 Issued in VT

Practice address

87 Paine Mountain Drive
Green Mountain Family Practice
Northfield, VT 05663

Phone

(802) 485-4161

Fax

(802) 485-4163

NPI assigned

Apr 29, 2013

Last updated

Aug 25, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VT, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

University of Vermont College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastern Aleutian Tribes, Inc.Group PAC ID 2860301884, 34 clinicians

Ketchikan Indian CorporationGroup PAC ID 8426043761, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peacehealth Ketchikan Medical Center Hospital, Ketchikan, AK, CCN 021311

Merit-based Incentive Payment System (MIPS)

Final score

70.59 of 100Reported as group

Quality

83.37

Promoting interoperability

100

Improvement activities

40

Cost

16.65

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Eastern Aleutian Tribes, Inc

  • Community Health Clinic/Center
  • King Cove, AK
  • NPI 1649332446

  TX

  Medicare reassignment Care Compare group NPD
• Ketchikan Indian Corporation

  dba KIC Tribal Health Clinic

  • Primary Care Clinic/Center
  • Ketchikan, AK
  • NPI 1821120486

  TX

  Medicare reassignment Care Compare group NPD
• Central Vermont Medical Center Inc

  • Family Medicine Physician
  • Berlin, VT
  • NPI 1023028784
  Medicare reassignment NPD
• Central Vermont Medical Center Inc

  dba Central Vermont Hospital

  • Internal Medicine Physician
  • Berlin, VT
  • NPI 1831374362
  Medicare reassignment NPD
• Seldovia Village Tribe

  • Federally Qualified Health Center (FQHC)
  • Homer, AK
  • NPI 1336178847

  TX

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Peacehealth

  dba Ketchikan Medical Center

  • Critical Access Hospital
  • Ketchikan, AK
  • NPI 1396705539
  Care Compare affiliation

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1912341306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "address_2": "ATT: CVMC FINANCE DEPT",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-485-4161",
            "fax_number": "802-485-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 PAINE MOUNTAIN DRIVE",
            "address_2": "GREEN MOUNTAIN FAMILY PRACTICE",
            "city": "NORTHFIELD",
            "state": "VT",
            "postal_code": "05663",
            "telephone_number": "802-485-4161",
            "fax_number": "802-485-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "LORETTA",
        "middle_name": "B.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-29",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "33 337930",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101.00113985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Botelho, ATC
• Kristin Brewer
• Ana Burtnett, PA-C
• Skylar Burzynski
• Tara Cariano
• Shelby Chicoine, RN
• Kevin Daniel Crowley, MD
• Sarah Lynn Davies, M.D.
• Viki C Delmas, OT
• Dog River Pharmacy Inc

• Family Nurse Practitioner in Northfield, VT
• Providers in Northfield, VT by specialty
• Family Nurse Practitioner in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.
• 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.

Verify at the official NPI Registry.