Organization Active NPI

Middlebury Radiologists, PLLC

  • Diagnostic Radiology Physician
  • Middlebury, VT
National Provider Identifier
1396857728
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MIDDLEBURY RADIOLOGISTS, PLLC
Practice address
115 Porter Dr
Middlebury, VT 05753-8423
Phone
(802) 388-8851
Fax
(802) 388-8821
NPI assigned
Aug 31, 2006
Last updated
Nov 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Authorized official

Name
Dr. Stephen M. Koller, M.D.NPI 1538197421
Title
Managing Partner
Phone
(802) 388-8851

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

115 Porter Dr
Middlebury, VT 05753-8423

Mailing address

1119 Basin Harbor Rd
Bridport, VT 05734-9570
Phone (802) 388-8851

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446681600000",
    "number": "1396857728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 BASIN HARBOR RD",
            "city": "BRIDPORT",
            "state": "VT",
            "postal_code": "057349570",
            "telephone_number": "802-388-8851",
            "fax_number": "802-388-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PORTER DR",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057538423",
            "telephone_number": "802-388-8851",
            "fax_number": "802-388-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLEBURY RADIOLOGISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-11-05",
        "status": "A",
        "authorized_official_last_name": "KOLLER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "802-388-8851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.