NORTHEAST KINGDOM HEALTHCARE COLLABORATIVE, LLC (NPI# 1215217641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215217641 |
| Entity Type | Organization |
| Organization Name | NORTHEAST KINGDOM HEALTHCARE COLLABORATIVE, LLC |
| Practice Address |
55 Sherman Drive St Johnsbury VT 05401 |
| Mailing Address |
55 Sherman Dr St Johnsbury VT 05819 |
| Practice Telephone | 8023344111 |
| Mailing Telephone | 8023347331 |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2011-09-14 |
| Authorized Official Name | MR. ANDRE BISSONNETTE (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 80233433253 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | NORTHEAST KINGDOM HEALTHCARE COLLABORATIVE, LLC | 55 Sherman Dr, St Johnsbury, VT 05819 |
| Street Address |
55 SHERMAN DRIVE |
| City | ST JOHNSBURY |
| State | VT |
| Zip Code | 05401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626748 | John Henry Priester Jr. | Student in an Organized Health Care Education/Training Program | University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT 05401 | 2020-03-27 |
| 1730649054 | Parisa Heidari | Student in an Organized Health Care Education/Training Program | Uvmmc 111 Colchester Avenue, Burlington, VT 05401 | 2019-03-22 |
| 1689141988 | No Diet Dietitian, LLC | Dietitian, Registered | 163 Bayberry Circle #204, Burlington, VT 05401 | 2018-10-25 |
| 1073097267 | Katherine Dwyer | Physical Therapist | 128 Lakeside Ave, Burlington, Vt, 05401, Burlington, VT 05401 | 2018-09-24 |
| 1710469481 | Nicholas A Fredette | Nurse Practitioner | 28 S. Williams St., Burlington, VT 05401 | 2018-08-30 |
| 1760987473 | Tyler Fanning | Psychiatry & Neurology | Uvmmv 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-26 |
| 1356845416 | Rachel Carlson | Student in an Organized Health Care Education/Training Program | Uvmmc, 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-22 |
| 1487152096 | Garnet Transport Medicine, LLC | Ambulance | 70 S Winooski Ave Ste 255, Burlington, VT 05401 | 2018-01-29 |
| 1689172660 | Valerie Goldberg | Dietitian, Registered | 163 Bayberry Circle Apt 204, Burlington, VT 05401 | 2018-01-25 |
| 1548774235 | Emily R Day | Physical Therapist | 160 Flynn Avenue, Burlington, VT 05401 | 2017-11-17 |
| Find all providers in zip 05401 | ||||
| Taxonomy Code | 207RS0012X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Sleep Medicine |
| An Internist who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic testing, diagnosis, management and prevention of sleep and circadian rhythm disorders. Sleep specialists treat patients of any age and use multidisciplinary approaches. Disorders managed by sleep specialists include, but are not limited to, sleep related breathing disorders, insomnia, hypersomnias, circadian rhythm sleep disorders, parasomnias and sleep related movement disorders. |
| Notes: Source: American Academy of Sleep Medicine, www.aasm.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083840813 | Weili Gray | Internal Medicine | 189 Prouty Dr, Newport, VT 05855 | 2009-06-08 |
| 1124296447 | Pulmonary Internists, Inc. | Internal Medicine | 139 Pearl St, Essex Jct, VT 05452-3659 | 2008-02-20 |
| 1699891192 | Innocent Chukwuma Ezenwa | Internal Medicine | 189 Prouty Dr, Newport, VT 05855-9326 | 2007-03-22 |
| City | ST JOHNSBURY |
| Zip Code | 05401 |
Please comment or provide details below to improve the information on NORTHEAST KINGDOM HEALTHCARE COLLABORATIVE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.