Individual provider Active NPI

Jody A Trombetta, LICSW

  • Clinical Social Worker
  • Rutland, VT
National Provider Identifier
1952481699
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0890000348 Issued in VT
Practice address
7 Court SQ
Rutland, VT 05701-4030
Phone
(802) 775-4388
Fax
(802) 775-3307
NPI assigned
Oct 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0890000348 VT Primary

Addresses

Primary practice location

7 Court SQ
Rutland, VT 05701-4030

Mailing address

78 Field Ave
Rutland, VT 05701-2313
Phone (802) 775-6665

Other identifiers 2

IdentifierTypeStateIssuer
0VN0700MedicaidVT
00029289OtherVTBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060322000474 VT Practitioner - Clinical Social Worker 1355359084 Practice locations: Rutland, VT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0890000348VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rutland Mental Health Services, Inc. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952481699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 FIELD AVE",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057012313",
            "telephone_number": "802-775-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 COURT SQ",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014030",
            "telephone_number": "802-775-4388",
            "fax_number": "802-775-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROMBETTA",
        "first_name": "JODY",
        "middle_name": "A",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "0890000348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN0700",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "00029289",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.