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Individual provider Active NPI

Carolyn Koulouris

  • Internal Medicine Physician
  • Burlington, VT
National Provider Identifier
1306283452
Registry record updated Sep 18, 2025
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Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
042-0015389 Issued in VT
Practice address
111 Colchester Ave
Burlington, VT 05401-1473
Phone
(802) 847-0000
NPI assigned
May 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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 042-0015389 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Burlington, VT 05401-1473

Mailing address

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

Other practice location 1

1 S Prospect St
Burlington, VT 05401-3456
Phone (802) 847-0000

Other practice location 2

353 Blair Park Rd
Williston, VT 05495-7530
Phone (802) 847-1470

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211118002628 VT Practitioner - Internal MedicinePractitioner - Family Practice 6305140195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Geisel School of Medicine at Dartmouth, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Vermont Medical Center IncGroup PAC ID 3779491071, 1,208 clinicians

Practice addresses (Care Compare)

353 Blair Rd
Williston, VT 05495
Phone (802) 347-1470

Hospital & facility affiliations

  • Uvmhn Home Health and Hospice Home health agency, Colchester, VT, CCN 477000
  • Bayada Home Health Care, Inc. Home health agency, Rutland, VT, CCN 477019
  • Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003
  • Northwestern Medical Center Inc Hospital, Saint Albans, VT, CCN 470024
  • The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250
  • Central Vermont Medical Center Hospital, Barre, VT, CCN 470001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Internal Medicine CurrentSince Nov 1, 2021 Accepting new patients

Locations

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

353 Blair Park Rd
Williston, VT 05495
Phone (802) 847-1440

Interoperability endpoints

  • Direct secure messaging: ckoulouris457973@direct.uvmhealth.org

Organizations & group practices 1

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 9

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": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1306283452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 S Prospect St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054013456",
            "country_code": "US",
            "telephone_number": "802-847-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "353 Blair Park Rd",
            "address_purpose": "LOCATION",
            "city": "Williston",
            "state": "VT",
            "postal_code": "054957530",
            "country_code": "US",
            "telephone_number": "802-847-1470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOULOURIS",
        "first_name": "CAROLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "042-0015389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.