MH 102, PC (NPI# 1457985590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457985590 |
| Entity Type | Organization |
| Organization Name | MH 102, PC |
| Practice Address |
193 Tilley Dr South Burlington VT 05403-4440 |
| Mailing Address |
Po Box 5 Winooski VT 05404-0005 |
| Practice Telephone | 8026511203 |
| Mailing Telephone | 8028570400 |
| Enumeration Date | 2020-02-27 |
| Last Update Date | 2020-02-27 |
| Authorized Official Name | 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 |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| PC Construction | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285268219 | Mh 102, PC | Nurse Practitioner | 1 Aflac Parkway, Columbus, GA 31907 | 2020-02-28 |
| 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 |
| 1053754275 | Mh 102, PC | Non-Pharmacy Dispensing Site | 5650 Main St, C/o Vcs Health Center, Manchester Center, VT 05255-9711 | 2013-04-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | MH 102, PC | Po Box 5, Winooski, VT 05404 |
| Street Address |
193 TILLEY DR |
| City | SOUTH BURLINGTON |
| State | VT |
| Zip Code | 05403-4440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659938975 | Josee-ann Guay | Student in an Organized Health Care Education/Training Program | 1060 Hinesburg Road Suite 201, South Burlington, VT 05403 | 2019-05-22 |
| 1821556390 | Alexander Taite Carpenter | Specialist/Technologist | 2069 Williston Road Ap #2, South Burlington, VT 05403 | 2019-03-04 |
| 1144732785 | Molly Koch Parker | Dietitian, Registered | 1233 Shelburne Rd Ste D2, South Burlington, VT 05403 | 2017-11-03 |
| 1497273007 | Marlena Anya Pecora | Acupuncturist | 368 Dorset St # 3, South Burlington, VT 05403 | 2017-09-03 |
| 1467908525 | Rinaben P Patel | Pharmacist | 39 Hinesburd Road, South Burlington, VT 05403 | 2016-08-29 |
| 1770949950 | Tara Flor | Chiropractor | 30 Farrell St Ste 100, South Burlington, VT 05403 | 2016-01-04 |
| 1356716187 | Frank Breen | Counselor | 163 Hinesburg Road, South Burlington, VT 05403 | 2015-12-04 |
| 1063808210 | Lisa C Harrington | Registered Nurse | Stone House Associates, 27 Rye Circle, South Burlington, VT 05403 | 2015-04-14 |
| 1083018626 | Jessica Jablonski | Speech-Language Pathologist | 2 Baldwin Ave, South Burlington, VT 05403 | 2014-10-10 |
| 1538590567 | Vasta Physical Therapy, Inc | Physical Therapist | 340 Dorset Street, Suite 2, South Burlington, VT 05403 | 2013-12-02 |
| Find all providers in zip 05403 | ||||
| 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 |
|---|---|---|---|---|
| 1124210570 | Deborah Moyer | Nurse Practitioner | 62 Tilley Dr Ste 101, South Burlington, VT 05403-4407 | 2007-08-09 |
| 1598735128 | Jennifer Laurent | Nurse Practitioner | 368 Dorset St Ste 1, South Burlington, VT 05403-6236 | 2006-01-25 |
| 1134742893 | Marathon Health LLC | Nurse Practitioner | 1 Kennedy Dr, South Burlington, VT 05403-7152 | 2020-05-28 |
| 1497232250 | Timothy Schad | Nurse Practitioner | 3 Timber Ln, South Burlington, VT 05403 | 2018-07-25 |
| 1578955761 | Trillium Integrative Medicine | Nurse Practitioner | 368 Dorset St, South Burlington, VT 05403-6236 | 2015-02-24 |
| 1124357215 | Leah Mariette Macaulay | Nurse Practitioner | 51 Timber Ln, South Burlington, VT 05403 | 2009-12-18 |
| 1346433851 | Rebecca A Nagle | Nurse Practitioner | 51 Timber Ln, South Burlington, VT 05403-5201 | 2007-08-20 |
| 1194757542 | Bob A. Lavalette | Nurse Practitioner | 6 San Remo Dr, South Burlington, VT 05403-6310 | 2006-07-07 |
| 1417908286 | Clodagh Coghlan | Nurse Practitioner | 368 Dorset St, Suite 1, South Burlington, VT 05403-6236 | 2006-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063020642 | Alma Matugas Winther | Nurse Practitioner | 154 Sullivan Dr, Putney, VT 05346-8664 | 2020-07-20 |
| 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 |
| 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 |
| 1609888684 | Durrelle T Whitmore | Nurse Practitioner | 720 Village Road, East Corinth, VT 05040 | 2006-08-11 |
| 1730111360 | Carrie J Norful | Nurse Practitioner | 4 Park St, Winooski, VT 05404-1549 | 2006-07-06 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BURLINGTON |
| Zip Code | 05403 |
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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.