Northeast Kingdom Hematology Oncology PLLC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

0420011226 Issued in VT

Legal business name

NORTHEAST KINGDOM HEMATOLOGY ONCOLOGY PLLC

Practice address

637 Union St
Newport, VT 05855-5498

Phone

(802) 334-7177

Fax

(802) 487-9299

NPI assigned

Apr 24, 2014

Last updated

Oct 28, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Leslie C Lockridge, MDNPI 1437133352

Title

Sole Proprietor/Sole Owner

Phone

(802) 334-7177

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Tax ID family

Northeast Kingdom Hematology Oncology PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Northeast Kingdom Hematology Oncology PLLC

  • Licensed Practical Nurse
  • Newport, VT
  • NPI 1174901342
  NPD tax ID

Practitioners 2

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.

• Leslie C Lockridge, MD

  • Hematology (Internal Medicine) Physician
  • Mountain Home, AR
  • NPI 1437133352

  Hematology & Oncology, VT

  Medicare reassignment NPD Authorized official
• Bruce D Latham, D.O.

  • Family Medicine Physician
  • Conway, NH
  • NPI 1356302491

  VT

  Medicare reassignment NPD

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1689094039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 838",
            "address_2": "637 UNION STREET",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058555498",
            "telephone_number": "802-334-7177",
            "fax_number": "802-487-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "637 UNION ST",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058555498",
            "telephone_number": "802-334-7177",
            "fax_number": "802-487-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST KINGDOM HEMATOLOGY ONCOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "LOCKRIDGE",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SOLE PROPRIETOR/SOLE OWNER",
        "authorized_official_telephone_number": "802-334-7177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "VT",
            "license": "0420011226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Country Supervisory Union
• North East Kingdom Community Action, Inc. (Nekca)
• Northeast Kingdom Community Action, Inc. (NEKCA Healthy Babies - Newport)
• Northeast Kingdom Community Action, Inc. (Nekca)
• Northeast Kingdom Hematology Oncology PLLC
• Northeast Kingdom Homecare, Inc.
• Northeast Kingdom Homecare, Inc.
• Northeast Kingdom Homecare, Inc. (The Meeting Place)
• Northeast Kingdom Human Services Inc
• Northeast Kingdom Human Services Inc Accs

• Hematology & Oncology Physician in Newport, VT
• Providers in Newport, VT by specialty
• Hematology & Oncology Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.