| Nvrh Kingdom Internal Medicine | |
|
714 Breezy Hill Road St Johnsbury VT 05819-0905 | |
| (805) 748-7500 | |
| (802) 745-1188 |
| Full Name | Nvrh Kingdom Internal Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 714 Breezy Hill Road, St Johnsbury, Vermont |
| Authorized Official Name and Position | Robert N Hersey (CFO) |
| Authorized Official Contact | 8027487520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nvrh Kingdom Internal Medicine Po Box 905 St Johnsbury VT 05819-0905 Ph: (802) 748-8141 | Nvrh Kingdom Internal Medicine 714 Breezy Hill Road St Johnsbury VT 05819-0905 Ph: (805) 748-7500 |
| NPI Number | 1871870899 |
|---|---|
| Provider Enumeration Date | 11/04/2011 |
| Last Update Date | 02/11/2020 |
| Medicare PECOS PAC ID | 3678481405 |
|---|---|
| Medicare Enrollment ID | O20120306000545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871870899 | NPI | - | NPPES |
| 3076793 | Medicaid | NH | |
| 0473991 | Medicaid | VT | |
| 1020004 | Medicaid | VT |
| Provider Name | Elizabeth R Newman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962437418 PECOS PAC ID: 8426010919 Enrollment ID: I20041027000893 |
| Provider Name | Thomas F Broderick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083646681 PECOS PAC ID: 0042229064 Enrollment ID: I20060419000188 |
| Provider Name | Jaime E Lipka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578739140 PECOS PAC ID: 7416021647 Enrollment ID: I20080805000772 |
| Provider Name | Jessica L Macleod |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336469337 PECOS PAC ID: 0244423804 Enrollment ID: I20101015000476 |
| Provider Name | Irene B Krechetoff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417250614 PECOS PAC ID: 7214157510 Enrollment ID: I20141009000539 |
| Provider Name | Tina K Heck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477958254 PECOS PAC ID: 4385967330 Enrollment ID: I20141223000816 |
| Provider Name | Joyce Vitale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154397206 PECOS PAC ID: 5698796993 Enrollment ID: I20160727000631 |
| Provider Name | Thomas A Myrter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528262722 PECOS PAC ID: 4587945951 Enrollment ID: I20171226001256 |
Concord Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 185 Sherman Dr, St Johnsbury, VT 05819 Phone: 802-695-2512 Fax: 802-695-1303 | |
Nvrh St. Johnsbury Pediatrics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 97 Sherman Drive, St Johnsbury, VT 05819 Phone: 802-748-5131 Fax: 802-748-4237 | |
Northern Express Care St. Johnsbury Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 Eastern Ave, St Johnsbury, VT 05819 Phone: 802-748-9405 | |
St. Johnsbury Community Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 185 Sherman Drive, Suite 1, St Johnsbury, VT 05819 Phone: 802-748-5401 Fax: 802-748-5094 | |
David S Brody, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1290 Hospital Dr, Suite 2, St Johnsbury, VT 05819 Phone: 802-748-2123 |