Katherine Devine, MD
Individual provider Active NPI Internal Medicine Physician · Windsor, VT
NPI 1386629202 · NPPES record last updated Jun 10, 2011
Key facts
- NPI
- 1386629202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 042-0011035 (VT)
- Practice address
- 289 County Rd
Windsor, VT 05089-9000 - Phone
- (802) 674-7300
- Fax
- (802) 674-7314
- NPI assigned
- Dec 14, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160524000918 | VT | Order and Referring Only - Internal Medicine |
2163441478 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0011035 | VT | MD | Internal Medicine Physician |
| 0420011035 | VT | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 042-0011035 | VT | Yes |
| General Practice Physician | 208D00000X | 0420011035 | VT |
Addresses
Primary practice location
289 County Rd
Windsor, VT 05089-9000
Mailing address
289 County Rd
Windsor, VT 05089-9000
Phone (802) 674-7300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1012052 | Medicaid | VT |
Other providers in Windsor, VT
- Connecticut Valley Addiction Recovery, Inc
- Connecticut Valley Recovery Services, Inc.
- Christopher C Connor
- Heidi M Cruz
- Elizabeth A Derry
- William Diez
- Ginger Dockum
- Dorina Kramer, DDS
- Ruth E Dougher
- Elizabeth Smith Therapy, LLC
All providers in Windsor, VT · 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 Jun 10, 2011. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.