Vickie L Kovar, C.R., LMT

Primary specialty

SpecialistTaxonomy code 174400000X

License

XXX0000000 Issued in CO

Practice address

511 Hearthstone Circle
Bartonsville, PA 18301

Phone

(570) 332-4365

NPI assigned

Apr 1, 2008

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 15, 2013.

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1114199874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 HEARTHSTONE CIRCLE",
            "city": "BARTONSVILLE",
            "state": "PA",
            "postal_code": "18301",
            "telephone_number": "570-332-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 HEARTHSTONE CIRCLE",
            "city": "BARTONSVILLE",
            "state": "PA",
            "postal_code": "18301",
            "telephone_number": "570-332-4365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVAR",
        "first_name": "VICKIE",
        "middle_name": "L",
        "credential": "C.R., LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CO",
            "license": "XXX0000000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARTFORD",
            "identifier": "509944311",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ GUARANTY ASSOCIATION",
            "identifier": "509944311",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.