Individual provider Active NPI

Denise Aileen Niemira, M.D.

  • Family Medicine Physician
  • Newport, VT
National Provider Identifier
1871688499
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
5452 U.S. RT. 5
Ste. D
Newport, VT 05855
Phone
(802) 334-6140
Fax
(802) 334-8271
NPI assigned
Oct 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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 VT Primary

Addresses

Primary practice location

5452 U.S. RT. 5
Ste. D
Newport, VT 05855

Mailing address

5452 U.S. RT. 5
Ste. D
Newport, VT 05855
Phone (802) 334-6140

Other identifiers 2

IdentifierTypeStateIssuer
VT.0007973MedicaidVT
8000428OtherVTLADIES FIRST PROVIDER NUM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060117000134 VT Practitioner - General Practice 0840214938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42-0005946VTMDFamily Medicine Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871688499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5452 U.S. RT. 5",
            "address_2": "STE. D",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "05855",
            "telephone_number": "802-334-6140",
            "fax_number": "802-334-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5452 U.S. RT. 5",
            "address_2": "STE. D",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "05855",
            "telephone_number": "802-334-6140",
            "fax_number": "802-334-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMIRA",
        "first_name": "DENISE",
        "middle_name": "AILEEN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VT.0007973",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LADIES FIRST PROVIDER NUM",
            "identifier": "8000428",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, VT

Sources for this page

Verify at the official NPI Registry.