Active NPI
Cold Hollow Family Practice
- Clinic Pharmacy
- Enosburg Falls, VT
National Provider Identifier
1902064496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic Pharmacy
- Legal business name
- COLD HOLLOW FAMILY PRACTICE
- Practice address
- 84 Water Tower Rd
Suite 1
Enosburg Falls, VT 05450-6097 - Phone
- (802) 933-6664
- Fax
- (802) 933-8333
- NPI assigned
- May 30, 2008
- Last updated
- May 30, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Candace M Collins
- Title
- Clinic Administrator
- Phone
- (802) 933-6664
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic Pharmacy | 3336C0002X | NU | Primary |
Addresses
Primary practice location
84 Water Tower Rd
Suite 1
Enosburg Falls, VT 05450-6097
Mailing address
84 Water Tower Rd
Suite 1
Enosburg Falls, VT 05450-6097
Phone (802) 933-6664
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1014837 | Medicaid | VT |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
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.
-
- Family Medicine Physician
- Enosburg Falls, VT
- NPI 1134115090
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212105600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1212105600000",
"number": "1902064496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 WATER TOWER RD",
"address_2": "SUITE 1",
"city": "ENOSBURG FALLS",
"state": "VT",
"postal_code": "054506097",
"telephone_number": "802-933-6664",
"fax_number": "802-933-8333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84 WATER TOWER RD",
"address_2": "SUITE 1",
"city": "ENOSBURG FALLS",
"state": "VT",
"postal_code": "054506097",
"telephone_number": "802-933-6664",
"fax_number": "802-933-8333"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COLD HOLLOW FAMILY PRACTICE",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-30",
"last_updated": "2008-05-30",
"status": "A",
"authorized_official_last_name": "COLLINS",
"authorized_official_first_name": "CANDACE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
"authorized_official_telephone_number": "802-933-6664"
},
"taxonomies": [
{
"code": "3336C0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Clinic Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1014837",
"state": "VT"
}
],
"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 May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.