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ESSEX PEDIATRICS PC NPI 1104925817


NPI Information

NPI: 1104925817
Provider Name: ESSEX PEDIATRICS PC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 47D0091383

Address:
89 MAIN ST
ESSEX JCT, VT
ZIP 05452
Phone: (802) 879-6556
Get Directions

ESSEX PEDIATRICS PC is a pediatrics in Essex Jct, VT. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. ESSEX PEDIATRICS PC NPI is 1104925817. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

89 MAIN ST
ESSEX JCT, VT
ZIP 05452-207
Phone: (802) 879-6556
Fax: (802) 872-8021

The provider's authorized official is Sue Rogers-low .
The authorized official title is Office Manager and has the following contact phone number (802) 879-6556.

The CLIA number assigned to this NPI record is 47D0091383 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/21/2006 and was last updated on 5/9/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics120475VERMONTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1OVN1603MEDICAIDVERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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