Individual provider Active NPI

Bruce R. Macpherson, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Burlington, VT
National Provider Identifier
1982621769
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
042-0005165 Issued in VT
Practice address
111 Colchester Ave
Fletcher Allen Health Care, Pathology
Burlington, VT 05401-1473
Phone
(802) 847-2397
Fax
(802) 847-3987
NPI assigned
Jul 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 042-0005165 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Fletcher Allen Health Care, Pathology
Burlington, VT 05401-1473

Mailing address

37 Elsom Pkwy
South Burlington, VT 05403-6606
Phone (802) 863-2436

Other identifiers 2

IdentifierTypeStateIssuer
00790029MedicaidNY
0004841MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0005165VTMDAnatomic Pathology & Clinical Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982621769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 ELSOM PKWY",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036606",
            "telephone_number": "802-863-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "FLETCHER ALLEN HEALTH CARE, PATHOLOGY",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-2397",
            "fax_number": "802-847-3987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACPHERSON",
        "first_name": "BRUCE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "VT",
            "license": "042-0005165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00790029",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0004841",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.