Long Trail Podiatry PLLC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

L0018421 Issued in VT

Legal business name

LONG TRAIL PODIATRY PLLC

Practice address

2456 Christian St
Suite L2
White River Junction, VT 05001-9856

Phone

(802) 359-4335

Fax

(802) 359-4336

NPI assigned

Apr 24, 2007

Last updated

Jun 10, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey R King, DPMNPI 1306065115

Title

Co-Owner

Phone

(802) 359-4335

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey R King, DPM

  • Podiatrist
  • Windsor, VT
  • NPI 1306065115
  NPD (past) Authorized official

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276128000000",
    "number": "1902025638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2456 CHRISTIAN ST",
            "address_2": "SUITE L2",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050019856",
            "telephone_number": "802-359-4335",
            "fax_number": "802-359-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2456 CHRISTIAN ST",
            "address_2": "SUITE L2",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050019856",
            "telephone_number": "802-359-4335",
            "fax_number": "802-359-4336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG TRAIL PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2010-06-10",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "802-359-4335",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "VT",
            "license": "L0018421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shari Lieblich, PHD
• Jean Y. Liu, MD
• Livewell Chiropractic PLLC
• Jill Anderson Lloyd, FNP
• Sarah E B Logan, M.D.
• Clifton Frederick Lord, MD
• Cameron Gail Lory, OD
• Brian Peter Lucas, M.D.
• Katie Lyford, RN
• Kerry Marie Lynch, AU.D.

• Podiatric Clinic/Center in White River Junction, VT
• Providers in White River Junction, VT by specialty
• Podiatric Clinic/Center in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; 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.