Kristine J Thomas, P.A.
Individual provider Active NPI Specialist · Burlington, VT
NPI 1093811366 · NPPES record last updated Jun 19, 2014
Key facts
- NPI
- 1093811366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 055-0030558 (VT)
- Practice address
- 111 Colchester Ave
Burlington, VT 05401-1473 - Phone
- (802) 847-0000
- Fax
- (802) 847-2537
- NPI assigned
- Sep 15, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070706000012 | VT | Practitioner - Physician Assistant | 6406956374 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055-0030558 | VT | MD | Specialist |
| PA437 | ME | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Vermont Medical Center Inc | Current |
Accepting new patients | |
| Porter Hospital, Inc | Current |
Accepting new patients | |
| Eastern Maine Medical Center | Past | Accepting new patients |
Locations
111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415
1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531
104 Porter Dr
Middlebury, VT 05753
Phone (802) 388-5682
82 Catamount Park
Middlebury, VT 05753
Phone (802) 388-7185
133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227
Interoperability endpoints
- kthomas10665@direct.uvmhealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 055-0030558 | VT | Yes |
Addresses
Primary practice location
111 Colchester Ave
Burlington, VT 05401-1473
Mailing address
111 Colchester Ave
Burlington, VT 05401-1473
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 795803 | Other | VT | MVP PROVIDER NUMBER |
| 59345 | Other | VT | BLUE CROSS PROVIDER NUMBE |
| 5734535 | Other | VT | CIGNA PROVIDER NUMBER |
Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.