Interventional Spine of Vermont, PLLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

INTERVENTIONAL SPINE OF VERMONT, PLLC

Practice address

277 Blair Park Rd Ste 110
Williston, VT 05495-7885

Phone

(802) 404-2004

Fax

(888) 506-2885

NPI assigned

Nov 23, 2020

Organization subpart

No

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

Authorized official

Name

Esther Caballero-Manrique, MD

Title

Physician Owner

Phone

(802) 404-2004

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606953600000",
    "number": "1497359103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1182",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054951182",
            "telephone_number": "802-404-2004",
            "fax_number": "888-506-2885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 BLAIR PARK RD STE 110",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957885",
            "telephone_number": "802-404-2004",
            "fax_number": "888-506-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE OF VERMONT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A",
        "authorized_official_last_name": "CABALLERO-MANRIQUE",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "802-404-2004",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Anesthesiology) Physician in Williston, VT
• Providers in Williston, VT by specialty
• Pain Medicine (Anesthesiology) Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.