NPIMap

Organization Active NPI

Northeastern Reproductive Medicine PLLC

  • Obstetrics & Gynecology Physician
  • Colchester, VT
National Provider Identifier
1982016689
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
NORTHEASTERN REPRODUCTIVE MEDICINE PLLC
Practice address
105 Westview Road
Suite 302
Colchester, VT 05446-5996
Phone
(802) 363-4935
Fax
(802) 985-2566
NPI assigned
May 29, 2014
Last updated
Aug 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Authorized official

Name
Peter Casson, MDNPI 1295741965
Title
Owner
Phone
(802) 363-4935

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Reproductive Endocrinology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VE0102X

Addresses

Primary practice location

105 Westview Road
Suite 302
Colchester, VT 05446-5996

Mailing address

105 Westview Road
Suite 302
Colchester, VT 05446-5996
Phone (802) 363-4935

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140807001693 VT Part B Supplier - Clinic/Group Practice 2365669736 Receives reassigned benefits from 6 practitioners
Practice locations: Colchester, VT

National Provider Directory

National Provider Directory

Locations

105 Westview Rd
Ste 302
Colchester, VT 05446
Phone (802) 655-8888

Practitioners & affiliated clinicians

Practitioners 6

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": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1982016689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WESTVIEW ROAD",
            "address_2": "SUITE 302",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054465996",
            "telephone_number": "802-363-4935",
            "fax_number": "802-985-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WESTVIEW ROAD",
            "address_2": "SUITE 302",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054465996",
            "telephone_number": "802-363-4935",
            "fax_number": "802-985-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN REPRODUCTIVE MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "CASSON",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-363-4935",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colchester, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.