Active NPI
Nicole R Hynes, MD
- Rheumatology Physician
- Burlington, VT
National Provider Identifier
1750415063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 0420011649
- Practice address
- 111 Colchester Ave
Rheumatology Acc 5TH Floor
Burlington, VT 05401-1473 - Phone
- (802) 847-4574
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 0600002821 | VT | |
| Rheumatology Physician | 207RR0500X | 0420011649 | VT | Primary |
Addresses
Primary practice location
111 Colchester Ave
Rheumatology Acc 5TH Floor
Burlington, VT 05401-1473
Mailing address
393 Twin Peaks Rd
Waterbury Center, VT 05677-7059
Phone (802) 244-8405
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1015498 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0420011649 | VT | MD | Rheumatology Physician |
| 0600002821 | VT | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251936000000",
"number": "1750415063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "393 TWIN PEAKS RD",
"city": "WATERBURY CENTER",
"state": "VT",
"postal_code": "056777059",
"telephone_number": "802-244-8405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 COLCHESTER AVE",
"address_2": "RHEUMATOLOGY ACC 5TH FLOOR",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054011473",
"telephone_number": "802-847-4574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HYNES",
"first_name": "NICOLE",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-16",
"last_updated": "2009-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "VT",
"license": "0600002821",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "VT",
"license": "0420011649",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1015498",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.