Individual provider Active NPI

Camille Zentkovich, FNP-C

  • Family Nurse Practitioner
  • Bennington, VT
National Provider Identifier
1245795129
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
101.0134818 Issued in VT
Practice address
655 Main St
Bennington, VT 05201-2870
Phone
(802) 447-2343
Fax
(802) 442-4636
NPI assigned
Feb 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN142752 GA
Family Nurse Practitioner 363LF0000X 101.0134818 VT Primary

Addresses

Primary practice location

655 Main St
Bennington, VT 05201-2870

Mailing address

600 Blair Park Rd Ste 285
Williston, VT 05495-7586
Phone (802) 288-1140

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cbrannon@pchpmd.medentdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210519000464 VT Practitioner - Nurse Practitioner 3779910880 Reassigns benefits to 1 organization
I20251022001479 NY Practitioner - Nurse Practitioner 3779910880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Primary Care Health Partners - Vermont LLPGroup PAC ID 7810896032, 21 clinicians
Certified Allergy Consultants, PCGroup PAC ID 2163413808, 9 clinicians

Practice addresses (Care Compare)

655 Main St
Bennington, VT 05201-2870
Phone (802) 447-2343

8 Southwoods Blvd
Suite 9
Albany, NY 12211-2554
Phone (518) 434-1446

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN142752GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Certified Allergy Consultants, PC CurrentSince Dec 29, 2025 Accepting new patients
Primary Care Health Partners - New York LLP CurrentSince Jul 2, 2023 Accepting new patients
Primary Care Health Partners - Vermont LLP CurrentSince May 17, 2021 Accepting new patients
Certified Allergy Consultants, PC PastSince Dec 29, 2025 Accepting new patients

Locations

8 Southwoods Blvd
Ste 9
Albany, NY 12211
Phone (518) 429-2643

8 Southwoods Blvd
Albany, NY 12211
Phone (518) 434-1446

7 Emma Ln
Clifton Park, NY 12065
Phone (518) 383-0001

2125 River Rd
Schenectady, NY 12309
Phone (518) 229-3339

655 Main St
Bennington, VT 05201
Phone (802) 447-2343

51 Timber Ln
South Burlington, VT 05403
Phone (802) 864-0521

66 Knight Ln
Ste 10
Williston, VT 05495
Phone (802) 872-4327

600 Blair Park Rd
Ste 285
Williston, VT 05495
Phone (802) 288-1140

Interoperability endpoints

  • Direct secure messaging: czentkovich@pchpmd.medentdirect.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1245795129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BLAIR PARK RD STE 285",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957586",
            "telephone_number": "802-288-1140",
            "fax_number": "802-288-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 MAIN ST",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052012870",
            "telephone_number": "802-447-2343",
            "fax_number": "802-442-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZENTKOVICH",
        "first_name": "CAMILLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-05",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN142752",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101.0134818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cbrannon@pchpmd.medentdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "655 Main St",
            "city": "Bennington",
            "state": "VT",
            "country_code": "US",
            "postal_code": "052012870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bennington, VT

Sources for this page

Verify at the official NPI Registry.