Judith M Kernodle, MD
Individual provider Active NPI Psychiatry Physician · Dorset, VT
NPI 1043373400 · NPPES record last updated Sep 16, 2021
Key facts
- NPI
- 1043373400
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- #25MAD6309000 (NJ)
- Practice address
- 2097 Route 30
Dorset, VT 05251-9411 - Phone
- (201) 819-6181
- NPI assigned
- Dec 18, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| #25MAD6309000 | NJ | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Village Plastic Surgery PC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | #25MAD6309000 | NJ | Yes |
Addresses
Primary practice location
2097 Route 30
Dorset, VT 05251-9411
Mailing address
2097 Route 30
Dorset, VT 05251-9411
Phone (201) 819-6181
Other providers in Dorset, VT
- Carolyn Goodwin
- Green Mountain House Calls, LLC
- Miguel Guardado Avelar
- Bradford Marshall Hammond
- Jackson Peak Counseling, PLLC
- Jody Lee Knapp
- Stephen R Longley
- Patricia A Michl
- Ewa S Mosiej-Polkosnik
- Mountain Valley, LLC
All providers in Dorset, VT · Psychiatry Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.