Middlebury Radiologists, PLLC

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

Organization subpart

No

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.

Title

Managing Partner

Phone

(802) 388-8851

Specialties & licenses 1

Addresses

Other identifiers 2

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "29573",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN1598",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Middlebury Eye Associates Inc
• Middlebury Family Health
• Middlebury Foot Care, Inc.
• Middlebury Pediatric Dentistry, PLLC
• Middlebury Physical Therapy PC
• Middlebury Sport and Spine, PLC
• Middlebury Volunteer Ambulance Association, Inc
• Middtown Dental PC
• Karen Miller-Lane, N.D., L.AC.
• Katie Casas Miller, M.D.

• All providers in Middlebury, VT
• Diagnostic Radiology Physician in Vermont

• 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.