Individual provider Active NPI

Peter M Thomashow, MD

  • Psychiatry Physician
  • Berlin, VT
National Provider Identifier
1114026614
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
042-0010046 Issued in VT
Practice address
130 Fisher Rd
Central Vermont Medical Center
Berlin, VT 05602
Phone
(802) 371-4316
Fax
(802) 371-4579
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 042-0010046 VT Primary

Addresses

Primary practice location

130 Fisher Rd
Central Vermont Medical Center
Berlin, VT 05602

Mailing address

PO Box 547
Att: Finance Dept
Barre, VT 05641-0547
Phone (802) 371-4316

Other identifiers 2

IdentifierTypeStateIssuer
VN229701OtherVTMEDICARE PTAN LINKED TO CVMC
OVN2297MedicaidVT

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0010046VTMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1114026614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "address_2": "ATT: FINANCE DEPT",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-371-4316",
            "fax_number": "802-371-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FISHER RD",
            "address_2": "CENTRAL VERMONT MEDICAL CENTER",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "05602",
            "telephone_number": "802-371-4316",
            "fax_number": "802-371-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMASHOW",
        "first_name": "PETER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042-0010046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN LINKED TO CVMC",
            "identifier": "VN229701",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN2297",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.