BENNINGTON FAMILY PRACTICE PLLC - NPI 1700835741 - Family Medicine in Bennington, VT

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

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About Bennington Family Practice Pllc NPPES

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

BENNINGTON FAMILY PRACTICE PLLC (NPI 1700835741) is a healthcare organization registered as a family medicine in Bennington, Vermont and active in the NPI registry since May 2006. The organization lists Elizabeth J Ellingsen, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1700835741

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameBENNINGTON FAMILY PRACTICE PLLC

Location Address339 DEWEY STBennington, VT 05201-2253

Mailing Address339 Dewey StBennington, VT 05201-2253 · (802) 447-1191 · Fax (802) 442-6614

Phone(802) 447-1191

Fax(802) 442-6614

Organization SubpartNo

Authorized OfficialElizabeth J EllingsenPractice Manager · (802) 447-1191

Enumeration DateMay 8, 2006

Last NPPES UpdateSeptember 29, 2015

✔ NPI 1700835741 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

339 DEWEY ST, Bennington, VT 05201

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Other Identifiers 3

Medicaid701100449VT

Medicaid8000038VT

Medicare UPINVT5610VT

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 2

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) 47D0689060

Bennington College Health Services · Bennington, VT

Active · expires Aug 31, 2026

CLIA Number47D0689060

Laboratory TypeSchool/Student Health Service

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorJohn E. Hearst

Laboratory Phone(802) 442-5401

Laboratory LocationBennington College Health ServicesCollege Drive, Bennington, VT 05201

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.

Certificate of Accreditation 47D1094791

Bennington Cboc · Bennington, VT

Expired · May 22, 2026

CLIA Number47D1094791

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateJanuary 27, 2009

Certificate Expiration DateMay 22, 2026

Laboratory DirectorDana Wolinski

Laboratory Phone(802) 447-6913

Laboratory LocationBennington Cboc186 North St, Bennington, VT 05201

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 8

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

G RICHARD DUNDAS MD

Internal Medicine