Individual provider Active NPI

Dayle Klitzner, MD

  • Family Medicine Physician
  • Middlebury, VT
National Provider Identifier
1841267721
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042-0007837 Issued in VT
Practice address
44 Collins Dr
Middlebury, VT 05753-8528
Phone
(802) 388-1500
Fax
(802) 388-0441
NPI assigned
Mar 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 042-0007837 VT Primary

Addresses

Primary practice location

44 Collins Dr
Middlebury, VT 05753-8528

Mailing address

44 Collins Dr
Middlebury, VT 05753-8528
Phone (802) 388-1500

Other identifiers 1

IdentifierTypeStateIssuer
0009438MedicaidVT

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

LicenseStateTypeSpecialty
042-0007837VTMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841267721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 COLLINS DR",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057538528",
            "telephone_number": "802-388-1500",
            "fax_number": "802-388-0441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 COLLINS DR",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057538528",
            "telephone_number": "802-388-1500",
            "fax_number": "802-388-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLITZNER",
        "first_name": "DAYLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042-0007837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009438",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.