Active NPI
Taylor Marika Lakusta-Wong, M.D.
- Student in an Organized Health Care Education/Training Program
- Burlington, VT
National Provider Identifier
1366185191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 111 Colchester Avenue
Uvmmc, Department of Neurology
Burlington, VT 05401 - Phone
- (802) 847-2345
- NPI assigned
- Apr 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
111 Colchester Avenue
Uvmmc, Department of Neurology
Burlington, VT 05401
Mailing address
111 Colchester Ave
University of Vermont Medical Center, Dept of Neurology
Burlington, VT 05401
Phone (802) 847-2345
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659657600000",
"number": "1366185191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 COLCHESTER AVE",
"address_2": "UNIVERSITY OF VERMONT MEDICAL CENTER, DEPT OF NEUROLOGY",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "05401",
"telephone_number": "802-847-2345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 COLCHESTER AVENUE",
"address_2": "UVMMC, DEPARTMENT OF NEUROLOGY",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "05401",
"telephone_number": "802-847-2345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKUSTA-WONG",
"first_name": "TAYLOR",
"middle_name": "MARIKA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-19",
"last_updated": "2022-08-05",
"certification_date": "2022-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.