Twin River Urology

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

0420008456 Issued in VT

Legal business name

TWIN RIVER UROLOGY

Practice address

108 No Main St
Twin River Urology
White River JCT, VT 05001

Phone

(802) 296-7370

Fax

(802) 296-7174

NPI assigned

Aug 21, 2006

Last updated

Jul 17, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Kathy L Detzer

Title

Bus Manager

Phone

(802) 296-7370

Specialties & licenses 2

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael R Curtis, MD

  • Urology Physician
  • Brunswick, ME
  • NPI 1518051481
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1205941879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 NO MAIN ST",
            "address_2": "TWIN RIVER UROLOGY",
            "city": "WHITE RIVER JCT",
            "state": "VT",
            "postal_code": "05001",
            "telephone_number": "802-296-7370",
            "fax_number": "802-296-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 NO MAIN ST",
            "address_2": "TWIN RIVER UROLOGY",
            "city": "WHITE RIVER JCT",
            "state": "VT",
            "postal_code": "05001",
            "telephone_number": "802-296-7370",
            "fax_number": "802-296-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN RIVER UROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "DETZER",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUS MANAGER",
        "authorized_official_telephone_number": "802-296-7370",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NH",
            "license": "8746",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "VT",
            "license": "0420008456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "0000301",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN0573",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Skyler Kardatzke, MA BCBA
• Robert Brooks Robey, MD
• Robert Thomas Sennett, RRT
• Gikanh Timberwolf, MA
• Town of Hartford School District
• White River Family Practice PC
• Steven Woloshin, MD
• Landon Wood, BSW

• Urology Physician in White River JCT, VT
• Providers in White River JCT, VT by specialty
• Urology Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.