Organization Active NPI

Middlebury Family Health

  • Health Maintenance Organization
  • Middlebury, VT
National Provider Identifier
1932159142
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
MIDDLEBURY FAMILY HEALTH
Practice address
1330 Exchange St Ste 201
Middlebury, VT 05753-4464
Phone
(802) 388-1500
Fax
(802) 388-0441
NPI assigned
May 10, 2006
Last updated
Oct 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Authorized official

Name
Stacy Lynn Ladd
Title
Practice Administrator
Phone
(802) 388-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

1330 Exchange St Ste 201
Middlebury, VT 05753-4464

Mailing address

1330 Exchange St Ste 201
Middlebury, VT 05753-4464
Phone (802) 388-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060502000705 VT Part B Supplier - Clinic/Group Practice 2668482811 Receives reassigned benefits from 10 practitioners
Practice locations: Middlebury, VT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
47D0677186Middlebury Family Health1330 Exchange St, Ste 201, Middlebury, VT 05753Provider-performed microscopyMar 6, 2028

National Provider Directory

National Provider Directory

Locations

1330 Exchange St
Ste 201
Middlebury, VT 05753
Phone (802) 388-1500

44 Collins Dr
Ste 201
Middlebury, VT 05753
Phone (802) 388-1500

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1932159142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 EXCHANGE ST STE 201",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057534464",
            "telephone_number": "802-388-1500",
            "fax_number": "802-388-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 EXCHANGE ST STE 201",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057534464",
            "telephone_number": "802-388-1500",
            "fax_number": "802-388-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLEBURY FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "LADD",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "802-388-1500"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.

Verify at the official NPI Registry.