GREEN MOUNTAIN FAMILY PRACTICE
NPI 1194701623
Clinic/Center - Primary Care in Northfield, VT

Active since December 16, 2005CLIA 47D0684748 · Microscopy
63 CRESCENT AVE, NORTHFIELD, VT 05663(802) 485-4161(802) 485-4163 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Green Mountain Family Practice NPPES

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

GREEN MOUNTAIN FAMILY PRACTICE (NPI 1194701623) is a healthcare organization registered as a primary care in Northfield, Vermont and active in the NPI registry since December 2005. The organization holds a CLIA Microscopy certificate valid through September 14, 2027 and lists Craig Demming Sullivan, Partner, as its authorized official.

NPPES Registry Identity

NPI1194701623
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameGREEN MOUNTAIN FAMILY PRACTICE
Location Address63 CRESCENT AVENorthfield, VT 05663-5704
Mailing Address63 Crescent AveNorthfield, VT 05663-5704 · (802) 485-4161 · Fax (802) 485-4163
Fax(802) 485-4163
Organization SubpartNo
Authorized OfficialCraig Demming SullivanPartner · (802) 485-4161
Enumeration DateDecember 16, 2005
Last NPPES UpdateAugust 22, 2020
NPI 1194701623 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
63 CRESCENT AVE, Northfield, VT 05663

Other Identifiers 1

Medicaid0005666VT

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 for Provider-Performed Microscopy Procedures (PPMP) 47D0684748

Green Mountain Family Practice · Northfield, VT
Active · expires Sep 14, 2027
CLIA Number47D0684748
Laboratory TypePhysician Office
Certificate Effective DateSeptember 15, 2025
Certificate Expiration DateSeptember 14, 2027
Laboratory DirectorMatthew D. Sullivan
Laboratory Phone(802) 485-4161
Laboratory LocationGreen Mountain Family Practice87 Paine Mountain Dr, Northfield, VT 05663
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 4

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

Family Medicine
63 CRESCENT AVE, GREEN MOUNTAIN FAMILY PRACTICE
NORTHFIELD, VT 05663
Family Medicine
63 CRESCENT AVE
NORTHFIELD, VT 05663
Family Medicine
63 CRESCENT AVE, GREEN MOUNTAIN FAMILY PRACTICE
NORTHFIELD, VT 05663
Physician Assistant
63 CRESCENT AVE, GREEN MOUNTAIN FAMILY PRACTICE
NORTHFIELD, VT 05663

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 Green Mountain Family Practice's NPI number?

The NPI number for Green Mountain Family Practice is 1194701623. It was assigned to this organization in the NPPES registry on December 16, 2005.

Where is Green Mountain Family Practice located?

Green Mountain Family Practice is located at 63 Crescent Ave, Northfield, VT 05663. The listed phone number is (802) 485-4161.

What is Green Mountain Family Practice's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Green Mountain Family Practice hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 47D0684748) is associated with this NPI, valid through September 14, 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 Green Mountain Family Practice was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.