WINOOSKI INTEGRATIVE MEDICINE PC
NPI 1619694478
Clinic/Center - Multi-Specialty in Winooski, VT
NPI Status: Active since October 24, 2022
Contact Information
321 MAIN ST STE B
WINOOSKI, VT
ZIP 05404
Phone: (802) 636-4133
- Organization
- Clinic/Center
- Multi-Specialty
- Accepts Insurance
- CLIA Number: 47D2272039
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 11-13-2026
About WINOOSKI INTEGRATIVE MEDICINE PC
This page provides the complete NPI Profile along with additional information for Winooski Integrative Medicine Pc, a provider established in Winooski, Vermont operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1619694478 assigned on October 2022. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated one year ago. Winooski Integrative Medicine Pc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Sam Russo Nd,lac, Rmsk (Principal)
- NPI
- 1619694478
- Provider Name
- WINOOSKI INTEGRATIVE MEDICINE PC
- Entity Type
- Organization
- Location Address
- 321 MAIN ST STE B WINOOSKI, VT 05404
- Location Phone
- (802) 636-4133
- Mailing Address
- 321 MAIN ST STE B WINOOSKI, VT 05404
- Mailing Phone
- (802) 636-4133
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-24-2022
- Last Update Date
- 02-14-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 171100000X | Other Service Providers | Acupuncturist | |
| 2 | 175F00000X | Other Service Providers | Naturopath | |
| 3 | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | |
| 4 | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Access Blue New England HMO 6000/20%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7000/50%/8000 w/HSA - HMO
- Anthem Bronze Access Blue New England HMO 7500/30%/10000 Value - HMO
- Anthem Bronze Access Blue New England HMO 8500/50%/9200 - HMO
- Anthem Gold Access Blue New England HMO 1000/20%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/0%/6500 RxD - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 2000/10%/7500 - HMO
- Anthem Gold Access Blue New England HMO 2000/20%/4600 w/HSA - HMO
- Anthem Gold Access Blue New England HMO 3000/0%/7500 RxD - HMO
- Anthem Gold Access Blue New England HMO 500/30%/9000 - HMO
- Anthem Platinum Access Blue New England HMO 250/10%/3500 - HMO
- Anthem Silver Access Blue New England HMO 2500/30%/10000 Value - HMO
- Anthem Silver Access Blue New England HMO 3000/30%/9000 Value - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/10000 - HMO
- Anthem Silver Access Blue New England HMO 3500/20%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 - HMO
- Anthem Silver Access Blue New England HMO 4000/0%/9000 RxD - HMO
- Anthem Silver Access Blue New England HMO 4000/10%/7250 w/HSA - HMO
- Anthem Silver Access Blue New England HMO 4000/20%/8500 - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1015129 | MEDICAID (05) | VT |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 47D2272039
- Facility Type
- Physician Office
- Certificate Effective Date
- November 14, 2024
- Certificate Expiration Date
- November 13, 2026
- Laboratory Director
- SAM RUSSO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Winooski Integrative Medicine Pc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1619694478, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 72 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619694478, enumerated as an "organization" on October 24, 2022.
The provider is located at 321 MAIN ST STE B WINOOSKI, VT 05404 and the phone number is (802) 636-4133.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Medicare and. Please consult your insurance carrier or call the provider to verify.
