MH 102, PC (NPI# 1053754275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053754275 |
| Entity Type | Organization |
| Organization Name | MH 102, PC |
| Other Organization Name | MH 102 AT VCS MANCHESTER |
| Practice Address |
5650 Main St C/o Vcs Health Center Manchester Center VT 05255-9711 |
| Mailing Address |
Po Box 5 Winooski VT 05404-0005 |
| Practice Telephone | 8027763670 |
| Practice Fax Number | 8028570498 |
| Mailing Telephone | 8028570400 |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2013-04-08 |
| Authorized Official Name | MS. BEVERLEY RAYMOND (PRESIDENT) |
| Authorized Official Telephone | 8028570400 |
| Authorized Official Credential | NP |
| Is Organization Subpart | Y |
| Parent Organization Name | MH 102, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332900000X | Non-Pharmacy Dispensing Site | Suppliers | ||
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| MH 102 at VCS Manchester | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285268219 | Mh 102, PC | Nurse Practitioner | 1 Aflac Parkway, Columbus, GA 31907 | 2020-02-28 |
| 1457985590 | Mh 102, PC | Nurse Practitioner | 193 Tilley Dr, South Burlington, VT 05403-4440 | 2020-02-27 |
| 1831723964 | Mh 102, PC | Nurse Practitioner | 1932 Wynnton Rd, Columbus, GA 31999-0001 | 2020-02-27 |
| 1174157218 | Mh 102, PC | Nurse Practitioner | 813 E 68th St Ste B, Savannah, GA 31405-4710 | 2020-02-27 |
| 1457985509 | Mh 102, PC | Nurse Practitioner | 5204 Bernard Dr Ste 300a, Roanoke, VA 24018-4345 | 2020-02-27 |
| 1588298624 | Mh 102, PC | Nurse Practitioner | 817 Botetourt Ct Ste 106, Chesapeake, VA 23320-4886 | 2020-02-27 |
| 1285105171 | Mh 102, PC | Nurse Practitioner | 2322 Blue Stone Hills Dr Ste 260, Harrisonburg, VA 22801-5403 | 2018-12-17 |
| 1811476286 | Mh 102, PC | Nurse Practitioner | 1020 Barrow Industrial Pkwy, Winder, GA 30680-3891 | 2018-08-07 |
| 1689177040 | Mh 102, PC | Nurse Practitioner | 98 Alexandria Pike Ste 52, Warrenton, VA 20186-2849 | 2018-03-13 |
| 1720599657 | Mh 102, PC | Nurse Practitioner | 864 Spring St Nw, Atlanta, GA 30308-1007 | 2017-10-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | MH 102, PC | Po Box 5, Winooski, VT 05404 |
| Street Address |
5650 MAIN ST C/O VCS HEALTH CENTER |
| City | MANCHESTER CENTER |
| State | VT |
| Zip Code | 05255-9711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920031 | Dakota Malik | Naturopath | 5138 Main Sreet, Manchester Center, VT 05255 | 2020-10-21 |
| 1619502648 | Kathleen Baroody | Counselor | 5312 Main Steet, Manchester Center, VT 05255 | 2020-03-10 |
| 1255971917 | Katherine Alice Schlageter | Psychologist | 5429 Main Street, Office C-2, Manchester Center, VT 05255 | 2020-01-10 |
| 1316332075 | Green Mountain House Calls, LLC | Nurse Practitioner | 994 Dorset West Road, Dorset, VT 05255 | 2015-03-31 |
| 1962727826 | Tamra F Mooney | Occupational Therapist | 3511 Richville Rd, Manchester, VT 05255 | 2010-04-05 |
| 1760649214 | Eric R Nisenson | Durable Medical Equipment & Medical Supplies | 7252 Main Street, Manchester Center, VT 05255 | 2008-05-21 |
| 1659591774 | Manchester Eye Care PC | Technician/Technologist | Village Mall 4363 Rte 7a, Manchester Center, VT 05255 | 2007-04-30 |
| 1306979687 | Geoffry Lee Campe | Dentist | 107 Bonnet St, Manchester Center, VT 05255 | 2007-03-14 |
| 1316087828 | John Ottesen | Dentist | 74 Longview Drive, Manchester Center, VT 05255 | 2007-02-07 |
| 1568526226 | Catherine Cech | Dentist | 5271 Main Street, Manchester Ctr, VT 05255 | 2006-12-20 |
| Find all providers in zip 05255 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063020642 | Alma Matugas Winther | Nurse Practitioner | 154 Sullivan Dr, Putney, VT 05346-8664 | 2020-07-20 |
| 1457985590 | Mh 102, PC | Nurse Practitioner | 193 Tilley Dr, South Burlington, VT 05403-4440 | 2020-02-27 |
| 1073147138 | Marathon Health LLC | Nurse Practitioner | 20 Winooski Falls Way Ste 400, Winooski, VT 05404-2239 | 2020-02-27 |
| 1306476981 | Morgan Lamson | Nurse Practitioner | Central Vermont Medical Center, 130 Fisher Road, Berlin, VT 05602 | 2020-01-22 |
| 1265086037 | Abbey Lynne Rouleau | Nurse Practitioner | Cvmc Palliative Care, 130 Fisher Road 2nd Floor, Berlin, VT 05602 | 2019-07-30 |
| 1104145069 | Shauna Mckeon | Nurse Practitioner | 1 Alden Pl, Vergennes, VT 05491-1102 | 2010-05-18 |
| 1952550691 | Susan Fagan Barry | Nurse Practitioner | St Michaels College Health, Smc Pob 259, Colchester, VT 05439-0001 | 2008-09-18 |
| 1124210570 | Deborah Moyer | Nurse Practitioner | 62 Tilley Dr Ste 101, South Burlington, VT 05403-4407 | 2007-08-09 |
| 1578697884 | Elise Marie Mcclintock | Nurse Practitioner | 5110 Middlebury College, Middlebury, VT 05753 | 2007-03-16 |
| 1235285693 | Nancy Lynne Duncan | Nurse Practitioner | 29 Reed St, Brattleboro, VT 05301-4455 | 2007-01-26 |
| Find all providers with the same taxonomy | ||||
| City | MANCHESTER CENTER |
| Zip Code | 05255 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.