Provider Demographics
NPI:1457304222
Name:ANN GOERING P.C.
Entity Type:Organization
Organization Name:ANN GOERING P.C.
Other - Org Name:WINOOSKI FAMILY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOERING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:802-655-4422
Mailing Address - Street 1:32 MALLETTS BAY AVE
Mailing Address - Street 2:
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-1959
Mailing Address - Country:US
Mailing Address - Phone:802-655-4422
Mailing Address - Fax:
Practice Address - Street 1:32 MALLETTS BAY AVE
Practice Address - Street 2:
Practice Address - City:WINOOSKI
Practice Address - State:VT
Practice Address - Zip Code:05404-1959
Practice Address - Country:US
Practice Address - Phone:802-655-4422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009381Medicaid
VTVN3122Medicare ID - Type Unspecified