Boreal Psychiatry PLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

BOREAL PSYCHIATRY PLC

Practice address

4185 St George Rd
Williston, VT 05495-7695

Phone

(802) 636-4545

NPI assigned

Jun 16, 2022

Organization subpart

No

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

Authorized official

Name

Kyle Monahan, MDNPI 1598269565

Title

Owner

Phone

(802) 636-4545

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyle Monahan, MD

  • Psychiatry Physician
  • Williston, VT
  • NPI 1598269565

  Psychiatry, VT

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655337600000",
    "number": "1780314211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4185 ST GEORGE RD",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957695",
            "telephone_number": "802-636-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4185 ST GEORGE RD",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957695",
            "telephone_number": "802-636-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOREAL PSYCHIATRY PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-16",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A",
        "authorized_official_last_name": "MONAHAN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-636-4545",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mei-Lani Bixby
• Zafir George Bludevich, PHYSICAL THERAPIST
• Blue Oak Counseling LLC
• Allison Marie Bogan, D.C.
• Aliza Bogner
• Lillian Marie Borek, MSW
• Melanie Bouchard
• Shannon Bouvier, ATC
• Anna Boziwick, BCBA
• Christina J.B. Bradford, AU.D.

• Psychiatry Physician in Williston, VT
• Providers in Williston, VT by specialty
• Psychiatry Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.