Northeastern Vermont Regional Hospital, Inc
Organization Active NPI Surgery Physician · St Johnsbury, VT
NPI 1992747737 · NPPES record last updated Apr 7, 2025
Key facts
- NPI
- 1992747737
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- NORTHEASTERN VERMONT REGIONAL HOSPITAL, INC
- Practice address
- 1315 Hospital Dr
St Johnsbury, VT 05819-9210 - Phone
- (802) 748-8141
- Fax
- (802) 748-4098
- NPI assigned
- Jun 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Andre Bissonnette
- Title
- Cfo
- Phone
- (802) 748-7520
Other NPIs with the same Medicare PAC ID 14
Member organizations 2
Practitioners 117
-
Eugene Joseph Dixon, M.D.
-
Ashley K Gerrish, NP
-
Amira H Ghazali, M.D.
-
Linda S. Kissane, AU.D.
-
Sara Azhar Zaidi, DPM
-
Britney Bigelow, APRN
-
Albert Fischer, CRNA
-
Byron Byrnes Holloway, D.O.
-
Autumn Sacklow, MD
-
Olivia Bellavance, PA-C
-
Trisha Mae Bullard, PA-C, PTA
-
Mark J Regis, PA
-
Peter Benjamin Schroer, M.D.
-
Laura Oakes Cannon, SLP
-
Sierra Caroleen Downs, MA CCC-SLP
-
Tamsin Melodie Durand, M.D.
-
Robert Kloos, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050411000154 | VT | Part B Supplier - Clinic/Group Practice | 3678481405 |
Receives reassigned benefits from 30 practitioners Practice locations: St Johnsbury, VT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician |
207Y00000X | |||
| Surgery Physician |
208600000X | Yes | ||
| Audiologist |
231H00000X | |||
| Critical Access Hospital | 282NC0060X | 673 | VT |
Addresses
Primary practice location
1315 Hospital Dr
St Johnsbury, VT 05819-9210
Mailing address
PO Box 905
St Johnsbury, VT 05819-0905
Phone (802) 748-8141
Other practice location 1
1290 Hospital Dr Ste 1
St Johnsbury, VT 05819-9205
Phone (802) 748-2984
Other practice location 2
1080 Hospital Dr Ste 5
St Johnsbury, VT 05819-6001
Phone (802) 748-5126
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1011326 | Medicaid | VT | |
| 3076797 | Medicaid | NH |
Other names
- NVRH Surgical Group
Other providers in St Johnsbury, VT
- Northeastern Vermont Regional Hospital, Inc
- Northeastern Vermont Regional Hospital, Inc
- Northeastern Vermont Regional Hospital, Inc
- Northeastern Vermont Regional Hospital, Inc
- Northeastern Vermont Regional Hospital, Inc
- Northeastern Vermont Regional Hospital, Inc.
- Northeastern Vermont Regional Hospital, Inc.
- Northeastern VT Reg Hosp
- Northern Counties Health Care
- Northern Counties Health Care Inc
All providers in St Johnsbury, VT · Surgery Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.