Active NPI
Debra Ann Vinick, PAC
- Dermatology Physician
- Vernon, CT
National Provider Identifier
1023026010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 000943
- Practice address
- 357 Hartford Turnpike
New England Dermatology Associates
Vernon, CT 06066 - Phone
- (860) 871-9441
- NPI assigned
- Aug 4, 2006
- Last updated
- Apr 24, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 000943 | CT | Primary |
Addresses
Primary practice location
357 Hartford Turnpike
New England Dermatology Associates
Vernon, CT 06066
Mailing address
357 Hartford Tpke
New England Dermatology Associates
Vernon, CT 06066-4838
Phone (860) 871-9441
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000943 | Other | CONNECTICARE | |
| 290000943CT01 | Other | ANTHEM BLUE SHIELD | |
| P2139469 | Other | OXFORD HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000943 | CT | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208995200000",
"number": "1023026010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "357 HARTFORD TPKE",
"address_2": "NEW ENGLAND DERMATOLOGY ASSOCIATES",
"city": "VERNON",
"state": "CT",
"postal_code": "060664838",
"telephone_number": "860-871-9441",
"fax_number": "860-871-0227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "357 HARTFORD TURNPIKE",
"address_2": "NEW ENGLAND DERMATOLOGY ASSOCIATES",
"city": "VERNON",
"state": "CT",
"postal_code": "06066",
"telephone_number": "860-871-9441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINICK",
"first_name": "DEBRA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2008-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CT",
"license": "000943",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "000943",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE SHIELD",
"identifier": "290000943CT01",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLAN",
"identifier": "P2139469",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Vernon, CT
- Vernon Manor Health Care Center, LLC
- Vernon Manor SNF Operations LLC
- Vernon Public Schools
- Vernon Urgent Care Center, LLC
- Sabitha Vignesh, MD
- Peter N Visgilio, PT
- Visiting Nurse & Health Services of Connecticut Inc
- Visiting Nurse & Health Services of Connecticut Inc
- Visiting Nurse & Health Services of Connecticut Inc
- Visiting Nurse & Health Services of Connecticut, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.