{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CENTRAL VERMONT MEDICAL CENTER INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 550",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BARRE",
"MailingAddressStateName": "VT",
"MailingAddressPostalCode": "05641-0550",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "802-371-4700",
"MailingAddressFaxNumber": "802-371-4720",
"FirstLinePracticeLocationAddress": "142 WOODRIDGE DR.",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BERLIN",
"PracticeLocationAddressStateName": "VT",
"PracticeLocationAddressPostalCode": "05602-9165",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "802-371-4700",
"PracticeLocationAddressFaxNumber": "802-371-4720",
"EnumerationDate": "10/04/2006",
"LastUpdateDate": "02/16/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HOLLAND",
"AuthorizedOfficialFirstName": "CHEYENNE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CFO",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "802-371-4109",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "270000165",
"LicenseNumberStateCode": "VT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}