Pines Health and Rehabilitation Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

0475044 Issued in VT

Legal business name

PINES HEALTH AND REHABILITATION CENTER

Practice address

601 Red Village Rd
Lyndonville, VT 05851-9068

Phone

(802) 626-3361

NPI assigned

Nov 7, 2007

Last updated

Aug 26, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Travis Bergeron Jr., DO

Title

Administrator

Phone

(802) 626-3361

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Pine Knoll Nursing Home Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pine Knoll Nursing Home, Inc

  dba Pines Rehabilitation & Health Center

  • Skilled Nursing Facility
  • Lyndonville, VT
  • NPI 1225000383
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756166400000",
    "number": "1023298015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 RED VILLAGE RD",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058519068",
            "telephone_number": "802-626-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 RED VILLAGE RD",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058519068",
            "telephone_number": "802-626-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINES HEALTH AND REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A",
        "authorized_official_last_name": "BERGERON",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "802-626-3361",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VT",
            "license": "0475044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225000383",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northern Physical Therapy PC
• Lindsay L O'Steen, PT, DPT
• Jennifer Natasha Omelianoff, BCBA
• Karey Leigh Pierce, MSPT
• Pine Knoll Nursing Home, Inc (Pines Rehabilitation & Health Center)
• Jonah E Plazek
• Valerie K Pollock, PTA, CNMT
• Post Acute Specialists of Vermont PLC
• Horace Oliver Reider, M.D.
• Riverside Life Enrichment Center Inc

• Skilled Nursing Facility in Lyndonville, VT
• Providers in Lyndonville, VT by specialty
• Skilled Nursing Facility in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.