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WINOOSKI INTEGRATIVE MEDICINE PC
NPI 1619694478
Clinic/Center - Multi-Specialty in Winooski, VT

Active since October 24, 2022CLIA 47D2272039 · Waiver
321 MAIN ST STE B, WINOOSKI, VT 05404(802) 636-4133 Get Directions Write a Review

NPPES record last updated: February 14, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 14, 2025, May 1, 2023, Oct 24, 2022 (3 updates tracked since 2022).

About Winooski Integrative Medicine Pc NPPES

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

WINOOSKI INTEGRATIVE MEDICINE PC (NPI 1619694478) is a healthcare organization registered as a multi-specialty in Winooski, Vermont and active in the NPI registry since October 2022. The organization holds a CLIA Waiver certificate valid through November 13, 2026 and lists Sam Russo, Principal, as its authorized official.

NPPES Registry Identity

NPI1619694478
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameWINOOSKI INTEGRATIVE MEDICINE PC
Location Address321 MAIN ST STE BWinooski, VT 05404-1380
Mailing Address321 Main St Ste BWinooski, VT 05404-1380 · (802) 636-4133
Phone(802) 636-4133
Organization SubpartNo
Authorized OfficialSam RussoPrincipal · (802) 636-4133
Enumeration DateOctober 24, 2022
Last NPPES UpdateFebruary 14, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 14, 2025
✔ NPI 1619694478 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedAcupuncturistTaxonomy 171100000X
Also ListedNaturopathTaxonomy 175F00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
321 MAIN ST STE B, Winooski, VT 05404
Open in Google Maps ↗

Other Identifiers 1

Medicaid1015129VT

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 Waiver 47D2272039

Winooski Integrative Medicine PC · Winooski, VT
Active · expires Nov 13, 2026
CLIA Number47D2272039
Laboratory TypePhysician Office
Certificate Effective DateNovember 14, 2024
Certificate Expiration DateNovember 13, 2026
Laboratory DirectorSam Russo
Laboratory Phone(802) 922-5091
Laboratory LocationWinooski Integrative Medicine PC321 Main St, Ste 203, Winooski, VT 05404
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only 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.

DR. VIRGINIA M. MACDONALD PH.D.
Psychologist (Clinical)
321 MAIN ST STE B
WINOOSKI, VT 05404
Chittenden County (802) 338-6374
KATLIN MOSTUE-NESBIT FNP
Nurse Practitioner (Family)
321 MAIN ST STE B
WINOOSKI, VT 05404
Chittenden County (802) 636-4133
LUCY B. D'APONTE M.S., P.T.
Physical Therapist
321 MAIN ST STE B
WINOOSKI, VT 05404
Chittenden County (802) 498-5959
DR. SAM RUSSO N.D., LAC, RMSK
Naturopath
321 MAIN ST STE B
WINOOSKI, VT 05404
Chittenden County (802) 636-4133

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 Winooski Integrative Medicine PC's NPI number?

The NPI number for Winooski Integrative Medicine PC is 1619694478. It was assigned to this organization in the NPPES registry on October 24, 2022.

Where is Winooski Integrative Medicine PC located?

Winooski Integrative Medicine PC is located at 321 Main St Ste B, Winooski, VT 05404. The listed phone number is (802) 636-4133.

What is Winooski Integrative Medicine PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Winooski Integrative Medicine PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 47D2272039) is associated with this NPI, valid through November 13, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Winooski Integrative Medicine PC accept?

Health plans from Anthem Blue Cross and Blue Shield list Winooski Integrative Medicine PC 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 Winooski Integrative Medicine PC was last updated on February 14, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.