Active NPI
Pierre Emile Etienne, MD
- Geriatric Psychiatry Physician
- Enosburg Falls, VT
National Provider Identifier
1831849090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Psychiatry Physician
- License
- 1.031592
- Practice address
- 3497 Reservoir Rd
Enosburg Falls, VT 05450-5966 - Phone
- (860) 333-3252
- NPI assigned
- Mar 28, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Psychiatry Physician | 2084P0805X | 1.031592 | CT | Primary |
Addresses
Primary practice location
3497 Reservoir Rd
Enosburg Falls, VT 05450-5966
Mailing address
3497 Reservoir Rd
Enosburg Falls, VT 05450-5966
Phone (860) 333-3252
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1.031592 | CT | MD | Geriatric Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648425600000",
"number": "1831849090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3497 RESERVOIR RD",
"city": "ENOSBURG FALLS",
"state": "VT",
"postal_code": "054505966",
"telephone_number": "860-333-3252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3497 RESERVOIR RD",
"city": "ENOSBURG FALLS",
"state": "VT",
"postal_code": "054505966",
"telephone_number": "860-333-3252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETIENNE",
"first_name": "PIERRE",
"middle_name": "EMILE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-28",
"last_updated": "2022-03-28",
"certification_date": "2022-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "CT",
"license": "1.031592",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enosburg Falls, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.