Individual provider Active NPI

Kathryn Gonzalez, MD

  • Internal Medicine Physician
  • Colchester, VT
National Provider Identifier
1285736090
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042-0010280 Issued in VT
Practice address
162 Hegeman Ave
#100
Colchester, VT 05446-3156
Phone
(802) 655-1356
Fax
(802) 655-1231
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 042-0010280 VT Primary

Addresses

Primary practice location

162 Hegeman Ave
#100
Colchester, VT 05446-3156

Mailing address

162 Hegeman Ave
#100
Colchester, VT 05446-3156

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161028000368 VT Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9537357843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
042-0010280VTMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285736090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 HEGEMAN AVE",
            "address_2": "#100",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054463156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 HEGEMAN AVE",
            "address_2": "#100",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054463156",
            "telephone_number": "802-655-1356",
            "fax_number": "802-655-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "KATHRYN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "042-0010280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colchester, VT

Sources for this page

Verify at the official NPI Registry.