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PEDIATRIC MEDICINE, PLC
NPI 1487701140
Pediatrics in South Burlington, VT

Active since January 04, 2007CLIA 47D0091266 · Certificate of Compliance
52 TIMBER LN, SOUTH BURLINGTON, VT 05403(802) 864-5004(802) 863-6933 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Pediatric Medicine, Plc NPPES

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

PEDIATRIC MEDICINE, PLC (NPI 1487701140) is a healthcare organization registered as a pediatrics in South Burlington, Vermont and active in the NPI registry since January 2007. The organization holds a CLIA Certificate of Compliance certificate valid through November 14, 2026 and lists Lisa Renee Bushee, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1487701140
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePEDIATRIC MEDICINE, PLC
Location Address52 TIMBER LNSouth Burlington, VT 05403-7204
Mailing Address52 Timber LnSouth Burlington, VT 05403-7204 · (802) 864-5004 · Fax (802) 863-6933
Phone(802) 864-5004
Fax(802) 863-6933
Organization SubpartNo
Authorized OfficialLisa Renee BusheeBusiness Manager · (802) 864-5004
Enumeration DateJanuary 4, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1487701140 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
52 TIMBER LN, South Burlington, VT 05403
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

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 Compliance 47D0091266

Pediatric Medicine Plc · South Burlington, VT
Active · expires Nov 14, 2026
CLIA Number47D0091266
Laboratory TypePhysician Office
Certificate Effective DateNovember 15, 2024
Certificate Expiration DateNovember 14, 2026
Laboratory DirectorJennifer Carlson MD
Laboratory Phone(802) 658-2320
Laboratory LocationPediatric Medicine Plc52 Timber Ln, South Burlington, VT 05403
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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.

DR. JENNIFER BERGERON CARLSON MD
Pediatrics
52 TIMBER LN
SOUTH BURLINGTON, VT 05403
Chittenden County (802) 658-2320
ANDREA BLOOD TIDMAN MD
Pediatrics
52 TIMBER LN
SOUTH BURLINGTON, VT 05403
Chittenden County (802) 658-2320

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 Pediatric Medicine, Plc's NPI number?

The NPI number for Pediatric Medicine, Plc is 1487701140. It was assigned to this organization in the NPPES registry on January 4, 2007.

Where is Pediatric Medicine, Plc located?

Pediatric Medicine, Plc is located at 52 Timber Ln, South Burlington, VT 05403. The listed phone number is (802) 864-5004.

What is Pediatric Medicine, Plc's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Pediatric Medicine, Plc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 47D0091266) is associated with this NPI, valid through November 14, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pediatric Medicine, Plc accept?

Health plans from Anthem Blue Cross and Blue Shield list Pediatric Medicine, Plc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pediatric Medicine, Plc 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.