Individual provider Active NPI

Thomas Kristiansen, M.D.

  • Orthopaedic Trauma Physician
  • Colchester, VT
National Provider Identifier
1861417537
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
Practice address
792 College Pkwy
Colchester, VT 05446-3052
Phone
(802) 847-4914
NPI assigned
Jul 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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
Orthopaedic Trauma Physician 207XX0801X VT Primary

Addresses

Primary practice location

792 College Pkwy
Colchester, VT 05446-3052

Mailing address

10 Knoll Cir
South Burlington, VT 05403-7639

Other identifiers 1

IdentifierTypeStateIssuer
0005587MedicaidVT

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
42-0006932VTMDOrthopaedic Trauma Physician

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861417537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 KNOLL CIR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 COLLEGE PKWY",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054463052",
            "telephone_number": "802-847-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTIANSEN",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005587",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colchester, 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.