TACONIC ESSENTIAL PRIMARY CARE
NPI 1023829876
Nurse Practitioner - Adult Health in Rutland, VT

Active since January 20, 2025CLIA 47D2326510 · Waiver
79 CENTER ST STE 1-1, RUTLAND, VT 05701(802) 683-7790 Get Directions Write a Review

NPPES record last updated: March 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Taconic Essential Primary Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TACONIC ESSENTIAL PRIMARY CARE (NPI 1023829876) is a healthcare organization registered as an adult health in Rutland, Vermont and active in the NPI registry since January 2025. The organization holds a CLIA Waiver certificate valid through July 6, 2027 and lists Matthew Todd Dayton, Owner/ Office Manager, as its authorized official.

NPPES Registry Identity

NPI1023829876
Entity TypeOrganization
Primary Taxonomy363LA2200X
Legal Business NameTACONIC ESSENTIAL PRIMARY CARE
Location Address79 CENTER ST STE 1-1Rutland, VT 05701-4061
Mailing Address79 Center St Ste 1-1Rutland, VT 05701-4061 · (802) 683-7790
Organization SubpartNo
Authorized OfficialMatthew Todd DaytonOwner/ Office Manager · (802) 683-7790
Enumeration DateJanuary 20, 2025
Last NPPES UpdateMarch 6, 2025
NPPES CertifiedMarch 6, 2025
NPI 1023829876 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
79 CENTER ST STE 1-1, Rutland, VT 05701

Other Identifiers 1

Medicaid6712491VT

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 47D2326510

Taconic Essential Primary Care · Rutland, VT
Active · expires Jul 6, 2027
CLIA Number47D2326510
Laboratory TypePhysician Office
Certificate Effective DateJuly 7, 2025
Certificate Expiration DateJuly 6, 2027
Laboratory DirectorTammy S. Devereux
Laboratory Phone(802) 772-7107
Laboratory LocationTaconic Essential Primary Care79 Center St, Ste 1, Rutland, VT 05701
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Adult Health)
79 CENTER ST STE 1-1
RUTLAND, VT 05701
Nurse's Aide
79 CENTER ST STE 1-1
RUTLAND, VT 05701

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Taconic Essential Primary Care's NPI number?

The NPI number for Taconic Essential Primary Care is 1023829876. It was assigned to this organization in the NPPES registry on January 20, 2025.

Where is Taconic Essential Primary Care located?

Taconic Essential Primary Care is located at 79 Center St Ste 1-1, Rutland, VT 05701. The listed phone number is (802) 683-7790.

What is Taconic Essential Primary Care's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Does Taconic Essential Primary Care hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 47D2326510) is associated with this NPI, valid through July 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Taconic Essential Primary Care was last updated on March 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.