NPIMap

Organization Active NPI

Champlain Valley Internal Medicine

  • Internal Medicine Physician
  • Saint Albans, VT
National Provider Identifier
1407999345
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CHAMPLAIN VALLEY INTERNAL MEDICINE
Practice address
77 Fairfield St
Saint Albans, VT 05478-1716
Phone
(802) 524-5617
Fax
(802) 527-7149
NPI assigned
Feb 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mark Silverstein, M.D.NPI 1083683304
Title
Physician
Phone
(802) 524-5617

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

77 Fairfield St
Saint Albans, VT 05478-1716

Mailing address

PO Box 1327
Williston, VT 05495-1327
Phone (802) 524-7100

Other identifiers 2

IdentifierTypeStateIssuer
0VN1746MedicaidVT
1013582MedicaidVT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407999345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1327",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054951327",
            "telephone_number": "802-524-7100",
            "fax_number": "802-524-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 FAIRFIELD ST",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054781716",
            "telephone_number": "802-524-5617",
            "fax_number": "802-527-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPLAIN VALLEY INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SILVERSTEIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "802-524-5617",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN1746",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013582",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.