NPIMap

Individual provider Active NPI

Kristina Myrtis Unikewicz

  • Family Nurse Practitioner
  • Swanton, VT
National Provider Identifier
1598315236
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
101.0134485 Issued in VT
Practice address
12 Church St
Swanton, VT 05488-1447
Phone
(802) 868-3175
NPI assigned
Sep 15, 2019
Last updated
Jun 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 101.0134485 VT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

12 Church St
Swanton, VT 05488-1447

Mailing address

12 Church St
Swanton, VT 05488-1447

Other practice location 1

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

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
I20200320001740 VT Practitioner - Nurse Practitioner 1052749272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fiddlehead Ledge LLCGroup PAC ID 1153711171, 2 clinicians

Practice addresses (Care Compare)

12 Church St
Suite 1
Swanton, VT 05488-1447
Phone (802) 868-3175

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fiddlehead Ledge LLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

12 Church St
Ste 1
Swanton, VT 05488
Phone (802) 868-3175

Organizations & group practices 1

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 8

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

NPI Registry JSON

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

{
    "created_epoch": "1568505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1598315236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 CHURCH ST",
            "city": "SWANTON",
            "state": "VT",
            "postal_code": "054881447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 CHURCH ST",
            "city": "SWANTON",
            "state": "VT",
            "postal_code": "054881447",
            "telephone_number": "802-868-3175"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Colchester Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054011473",
            "country_code": "US",
            "telephone_number": "802-847-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UNIKEWICZ",
        "first_name": "KRISTINA",
        "middle_name": "MYRTIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-15",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101.0134485",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Swanton, VT

Sources for this page

Verify at the official NPI Registry.