NPIMap

Organization Active NPI

Northwestern Medical Center, Inc.

  • Dermatology Physician
  • Saint Albans, VT
National Provider Identifier
1932575792
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NORTHWESTERN MEDICAL CENTER, INC.
Doing business as
Northwestern Dermatology
Practice address
128 Fisher Pond Rd
2ND Floor
Saint Albans, VT 05478-6058
Phone
(802) 524-9707
Fax
(802) 752-1361
NPI assigned
Aug 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Authorized official

Name
Mary E Pigeon
Title
Credentialing Specialist
Phone
(802) 524-8954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

128 Fisher Pond Rd
2ND Floor
Saint Albans, VT 05478-6058

Mailing address

128 Fisher Pond Rd
2ND Floor
Saint Albans, VT 05478-6058
Phone (802) 524-9707

Other names 1

  • Northwestern Dermatology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northwestern Medical Center36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1932575792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 FISHER POND RD",
            "address_2": "2ND FLOOR",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054786058",
            "telephone_number": "802-524-9707",
            "fax_number": "802-752-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 FISHER POND RD",
            "address_2": "2ND FLOOR",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054786058",
            "telephone_number": "802-524-9707",
            "fax_number": "802-752-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-17",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "PIGEON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "802-524-8954"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwestern Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northwestern Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Albans, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.