COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC. (NPI# 1073567590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073567590 |
| Entity Type | Organization |
| Organization Name | COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC. |
| Other Organization Name | DBA BRANDON MEDICAL CENTER |
| Practice Address |
420 Grove St Brandon VT 05733-9062 |
| Mailing Address |
71 Allen St Suite 101 Rutland VT 05701-4570 |
| Practice Telephone | 8022476305 |
| Practice Fax Number | 8022476040 |
| Mailing Telephone | 8004689118 |
| Mailing Fax Number | 8027727973 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2018-09-11 |
| Authorized Official Name | MICHAEL GARDNER (FINANCE DIRECTOR) |
| Authorized Official Telephone | 8028552083 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 1010852 | 05 | |
| VT | 0471814 | 05 | |
| NY | 03044057 | 05 |
| Other Name | Type Code |
|---|---|
| dba Brandon Medical Center | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225400237 | Community Health Centers of The Rutland Region, Inc. | Family Medicine | 71 Allen Pond, Suite 403, Rutland, VT 05701-4570 | 2015-10-29 |
| 1780969345 | Community Health Centers of The Rutland Region, Inc. | Clinic/Center | 1 General Wing Rd, Rutland, VT 05701-4681 | 2011-10-14 |
| 1437364759 | Community Health Centers of The Rutland Region, Inc. | Dentist | 69 Allen St Ste 10, Rutland, VT 05701-4564 | 2007-05-11 |
| 1104870922 | Community Health Centers of The Rutland Region, Inc. | Clinic/Center | 278 Vt Route 149, West Pawlet, VT 05775-9798 | 2006-05-19 |
| 1336193838 | Community Health Centers of The Rutland Region, Inc. | Family Medicine | 275 Route 30 N, Bomoseen, VT 05732-9647 | 2006-05-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC. | 275 Rte 30 North, Bomoseen, VT 05732 |
| Street Address |
420 GROVE ST |
| City | BRANDON |
| State | VT |
| Zip Code | 05733-9062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720074743 | George C Fjeld | Family Medicine | 420 Grove St, Brandon, VT 05733-9062 | 2005-09-26 |
| 1831565597 | Abigail Stanton Wikoff | Nurse Practitioner | 420 Grove St, Brandon, VT 05733-9062 | 2015-08-18 |
| 1497146377 | Amy Kittredge | Counselor | 420 Grove St, Brandon, VT 05733-9062 | 2015-02-12 |
| 1346585247 | Laura G Ethier | Social Worker | 420 Grove St, Brandon, VT 05733-9062 | 2012-12-03 |
| 1902166523 | Stefanie Buffum | Clinic/Center | 420 Grove St, Brandon, VT 05733-9062 | 2012-05-17 |
| 1992094528 | Elizabeth Anne Sheldon-morris | Physician Assistant | 420 Grove St, Brandon, VT 05733-9062 | 2011-04-05 |
| 1760700538 | Dba Brandon Community Pharmacy | Pharmacist | 420 Grove St, Brandon, VT 05733-9062 | 2010-05-04 |
| 1073533048 | John F Dick II | Internal Medicine | 420 Grove St, Brandon, VT 05733-9062 | 2006-07-20 |
| 1609896604 | Robin L Myers | Nurse Practitioner | 420 Grove St, Brandon Internal Medicine, Brandon, VT 05733-9062 | 2006-07-20 |
| 1023041431 | Kim Kurak | Family Medicine | 420 Grove St, Brandon, VT 05733-9062 | 2006-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275919011 | James Aaron Bartshe | Counselor | 146 Lake Hortonia Road, Sudbury, VT 05733 | 2015-08-04 |
| 1255668562 | Aliceanne Lavallee | Massage Therapist | 422 Schoolhouse Road, Sudbury, VT 05733 | 2009-11-06 |
| 1336361799 | Middlebury Physical Therapy PC | Physical Medicine & Rehabilitation | 295 Colonial Drive, Middlebury, VT 05733 | 2007-05-03 |
| 1568586667 | Benjamin Franklin Lawton | Dentist | 5 Carver St., Brandon, VT 05733 | 2007-03-16 |
| 1336767755 | Green Mountain Psychology Pllc | Clinic/Center | 29 Union Street, The Granary, First Floor, Brandon, VT 05733 | 2020-07-13 |
| 1609896935 | Porter Hospital Inc | Family Medicine | 61 Court Dr, Neshobe Family Medicine, Brandon, VT 05733 | 2006-07-20 |
| 1417571100 | Elizabeth D.c. Taylor | Psychologist | The Granary, 29 Union Street, Brandon, VT 05733-0573 | 2020-05-29 |
| 1295197549 | John Humphreys | Specialist | 8 Conant Sq, Brandon, VT 05733-1018 | 2016-03-25 |
| 1740588979 | Gregor Allen Outslay | Pharmacist | 1 Carver St, Brandon, VT 05733-1103 | 2011-03-12 |
| 1023113040 | Thomas A Coleman | Dentist | 5 Carver St, Brandon, VT 05733-1103 | 2006-09-14 |
| Find all providers in zip 05733 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900581 | Maegan Cook Bridges | Family Medicine | 312 Ridge Pointe Dr, Brandon, MS 39042-5035 | 2020-10-24 |
| 1346887353 | Kelli Marie Foster | Family Medicine | 515 Belle Oak Pl, Brandon, MS 39042-8111 | 2019-12-09 |
| 1649764127 | Specialty Diagnostics LLC | Family Medicine | 1149 Old Fannin Rd Ste 22, Brandon, MS 39047 | 2018-06-19 |
| 1033566161 | Medi Brandon LLC | Family Medicine | 203 W Bloomingdale Ave, Brandon, FL 33511-7404 | 2016-05-18 |
| 1144659178 | Medical Foundation of Central Ms, Inc | Family Medicine | 1887 Spillway Rd., Brandon, MS 39047 | 2013-11-12 |
| 1457780637 | Jennifer Packing-ebuen | Family Medicine | 426w Brandon Blvd, Brandon, FL 33511-5002 | 2013-11-07 |
| 1548698608 | St Dominic Medical Associates LLC | Family Medicine | 1297 West Government Street, Brandon, MS 39042 | 2013-10-28 |
| 1265780910 | Uc1, LLC | Family Medicine | 799 Lumsden Rd, Brandon, FL 33511 | 2012-08-28 |
| 1992082721 | Mathew Medical Consulting Pa | Family Medicine | 635 Tuscanny St, Brandon, FL 33511-6165 | 2011-11-08 |
| 1003192246 | Sandra Dorsey | Family Medicine | 122 South Moon Avenue, Brandon, FL 33511 | 2011-11-02 |
| Find all providers in BRANDON | ||||
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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.