THERESA HETZLER (NPI# 1619978293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619978293 |
| Entity Type | Individual |
| Full Name | THERESA HETZLER |
| Credential | MD |
| Practice Address |
617 Riverside Ave Burlington VT 05401-1601 |
| Practice Telephone | 8028646309 |
| Practice Fax Number | 8028604313 |
| Mailing Telephone | 8028646309 |
| Mailing Fax Number | 8028604313 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2018-06-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 042.0013055 | VT | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 181118 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01263758 | 05 |
| Street Address |
617 RIVERSIDE AVE |
| City | BURLINGTON |
| State | VT |
| Zip Code | 05401-1601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689678963 | Community Health Centers of Burlington Inc | Family Medicine | 617 Riverside Ave, Burlington, VT 05401-1601 | 2005-06-02 |
| 1225652571 | Rachel Ivancie | Registered Nurse | 617 Riverside Ave, Burlington, VT 05401-1601 | 2020-06-02 |
| 1588295315 | Emily-anne Sanders Garcia | Social Worker | 617 Riverside Ave, Burlington, VT 05401-1601 | 2020-01-30 |
| 1992336234 | Stephanie Szkaradnik | Social Worker | 617 Riverside Ave, Burlington, VT 05401-1601 | 2020-01-27 |
| 1699312025 | Sabrina Leal | Social Worker | 617 Riverside Ave, Burlington, VT 05401-1601 | 2019-12-04 |
| 1558828111 | Meaghan Moran Mcfadden | Social Worker | 617 Riverside Ave, Burlington, VT 05401 | 2019-03-01 |
| 1912446097 | Zachary Schwartz | Nurse Practitioner | 617 Riverside Ave, Burlington, VT 05401-1601 | 2017-02-22 |
| 1295279628 | Samuel Lurie | Social Worker | 617 Riverside Ave, Burlington, VT 05401-1601 | 2016-12-03 |
| 1346796463 | Kristen Vinci Gray | Nurse Practitioner | 617 Riverside Ave, Burlington, VT 05401-1601 | 2016-08-29 |
| 1518328749 | Jessica A Griffin | Registered Nurse | 617 Riverside Ave, Burlington, VT 05401-1601 | 2016-03-16 |
| Find all providers in the same location | ||||
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215177498 | Adrea D Theodore | Pediatrics | 1206-b Vaughn Road, Burlington, NC 27216 | 2009-02-27 |
| 1992951404 | Howard R. Grant | Pediatrics | Lahey Health System, 41 Mall Rd., Burlington, MA 01805-0001 | 2008-08-15 |
| 1295900793 | Mdfamily Medical Group | Pediatrics | 1205 Maple Ave, Burlington, NC 27215-6958 | 2008-04-25 |
| 1790863058 | Warren Kent Bonney | Pediatrics | 3804 S Church St, Burlington, NC 27215-9134 | 2006-11-02 |
| 1740203215 | Catherine Suzanne Rude | Pediatrics | One South Prospect Street, University Pediatrics, Burlington, VT 05401 | 2006-07-25 |
| 1316968142 | Lewis R. First | Pediatrics | Given Courtyard S 250, Burlington, VT 05405-0001 | 2006-07-21 |
| 1699709519 | Karin Reed Minter | Pediatrics | 530 W Webb Ave, Burlington, NC 27217-3706 | 2006-07-10 |
| 1003859943 | Marcia L Moran | Pediatrics | 2105 Maple Ave, Burlington, NC 27215-6853 | 2006-06-14 |
| 1699726729 | Wendy Sue Davis | Pediatrics | 108 Cherry St, Burlington, VT 05401 | 2006-05-13 |
| 1588621544 | Margarita Maria Goldar | Pediatrics | 113 Trail One, Burlington, NC 27215-5531 | 2006-04-26 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 05401 |
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| 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.