# GREEN MOUNTAIN PEDIATRICS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073617783
- **Authorized official:** DR. JUDY K ORTON MD PA (PRESIDENT DIRECTOR)
- **Authorized official phone:** (802) 442-6057

## Contact information

- **Practice address:** 901 MAIN STREET, SUITE 1, BENNINGTON, VT 05201
- **Practice address phone:** (802) 442-6057
- **Practice address fax:** (802) 447-1348
- **Mailing address:** 901 MAIN STREET, SUITE 1, BENNINGTON, VT 05201
- **Mailing address phone:** (802) 442-6057
- **Mailing address fax:** (802) 447-1348

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | VT | Yes |

## Other

- **Enumeration date:** 09/12/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0427959 | CIGNA | — |
| 01 | — | 10017477 | CDPHP | — |
| 05 | — | 1006759 | — | VT |
| 01 | — | 26188 | MVP | — |
| 01 | — | 33748798 | BCBS | VT |