NPIMap

Organization Active NPI

Northeast Kingdom Human Services Inc MH Children

  • Adolescent and Children Mental Health Clinic/Center
  • Newport, VT
National Provider Identifier
1043343700
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
NORTHEAST KINGDOM HUMAN SERVICES INC MH CHILDREN
Practice address
154 Duchess St
Newport, VT 05855
Phone
(802) 334-6744
Fax
(802) 334-7340
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Eric Grims
Title
Chief Executive Officer
Phone
(802) 334-6744

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

154 Duchess St
Newport, VT 05855

Mailing address

PO Box 724
Newport, VT 05855-0724
Phone (802) 334-6744

Other identifiers 1

IdentifierTypeStateIssuer
1009784MedicaidVT

National Provider Directory

National Provider Directory
Tax ID family
Northeast Kingdom Human Services Inc17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043343700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 724",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058550724",
            "telephone_number": "802-334-6744",
            "fax_number": "802-334-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 DUCHESS ST",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "05855",
            "telephone_number": "802-334-6744",
            "fax_number": "802-334-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST KINGDOM HUMAN SERVICES INC MH CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRIMS",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "802-334-6744",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009784",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.