Northeast Kingdom Healthcare Collaborative, LLC
Organization Active NPI Sleep Medicine (Internal Medicine) Physician · St Johnsbury, VT
NPI 1215217641 · NPPES record last updated Sep 24, 2025
Key facts
- NPI
- 1215217641
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Sleep Medicine (Internal Medicine) Physician 207RS0012X
- Legal business name
- NORTHEAST KINGDOM HEALTHCARE COLLABORATIVE, LLC
- Practice address
- 468 Hospital Drive
St Johnsbury, VT 05819 - Phone
- (802) 748-7901
- Fax
- (802) 427-3047
- NPI assigned
- Aug 17, 2011
- Organization subpart
- No
Authorized official
- Name
- Deborah L Brown
- Title
- Enrollment Specialist
- Phone
- (802) 487-2589
Member of 2
Practitioners 6
-
Weili Gray, M.D.
-
Patrick Heaney, PA/C
-
Lori L. Koshowski, CRNP
-
Arthur D Alsobrook, JR., M.D.
-
Danielle L Speer, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111122000009 | VT | Part B Supplier - Clinic/Group Practice | 5698949097 |
Receives reassigned benefits from 6 practitioners Practice locations: St Johnsbury, VT |
National Provider Directory
Locations
186 Medical Village Dr
#1
Newport, VT 05855
Phone (802) 334-3262
468 Hospital Dr
#2
St Johnsbury, VT 05819
Phone (802) 334-4108
55 Sherman Dr
St Johnsbury, VT 05819
Phone (802) 334-4108
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sleep Medicine (Internal Medicine) Physician |
207RS0012X | Yes |
Addresses
Primary practice location
468 Hospital Drive
St Johnsbury, VT 05819
Mailing address
186 Medical Village Dr, Suite 1
Newport, VT 05855
Phone (802) 487-2589
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1019637 | Medicaid | VT |
Other providers in St Johnsbury, VT
- Stephen G Nolker
- Robert Michael Norris
- North Country Chiropractic Center PLLC
- North East Kingdom Community Action, Inc.
- Northeast Kingdom Council on Aging
- Northeast Kingdom Occupational Therapy
- Northeast Kingdom Trauma Intensives
- Northeastern Vermont Regional Hospial
- Northeastern Vermont Regional Hospital
- Northeastern Vermont Regional Hospital Dietary Clinic
All providers in St Johnsbury, VT · Sleep Medicine (Internal Medicine) 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 24, 2025. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.