NPIMap

Individual provider Active NPI

Kathryn Zoll, PA-C

  • Physician Assistant
  • Middlebury, VT
National Provider Identifier
1487106043
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
055-0031319 Issued in VT
Practice address
115 Porter Dr
Middlebury, VT 05753-8423
Phone
(802) 388-4701
NPI assigned
Oct 31, 2016
Last updated
Dec 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 055.0031319 VT
Physician Assistant 363A00000X 055-0031319 VT Primary

Addresses

Primary practice location

115 Porter Dr
Middlebury, VT 05753-8423

Mailing address

40 Middle Seymour St
Middlebury, VT 05753-1291
Phone (727) 698-8599

Other names 1

  • Kathryn Samuel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161130000374 VT Practitioner - Physician Assistant 2365722832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Porter Hospital IncGroup PAC ID 1850365180, 116 clinicians

Practice addresses (Care Compare)

115 Porter Dr
Middlebury, VT 05753-8423
Phone (802) 388-4701

61 Court Dr
Brandon, VT 05733-8407
Phone (802) 247-3755

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
055-0031319VTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Porter Hospital Inc Current Accepting new patients

Locations

115 Porter Dr
Middlebury, VT 05753
Phone (802) 388-4701

Interoperability endpoints

  • Direct secure messaging: kzoll236003@direct.uvmhealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1487106043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 MIDDLE SEYMOUR ST",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057531291",
            "telephone_number": "727-698-8599"
        },
        {
            "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": "802-388-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOLL",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VT",
            "license": "055.0031319",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055-0031319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "SAMUEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Middlebury, VT

Sources for this page

Verify at the official NPI Registry.