Northern Vermont Dermatology, PLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

0420013164 Issued in VT

Legal business name

NORTHERN VERMONT DERMATOLOGY, PLC

Practice address

53 Fairfax Rd Ste 2
Saint Albans, VT 05478-4405

Phone

(833) 688-3376

NPI assigned

Jun 29, 2018

Last updated

Nov 23, 2020By 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

Stephanie Dawn NeiderNPI 1386678381

Title

Owner

Phone

(833) 688-3376

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

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.

• Stephanie Dawn Neider, M.D.

  • Dermatology Physician
  • Saint Albans, VT
  • NPI 1386678381
  Medicare reassignment NPD Authorized official
• Julie Hsiao-Wen Lin, MD

  • Dermatology Physician
  • Saint Albans, VT
  • NPI 1063572907
  Medicare reassignment NPD
• Patricia L. Seal, M.D.

  • Dermatology Physician
  • South Burlington, VT
  • NPI 1730273509
  NPD (past)

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1922593060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 FAIRFAX RD STE 2",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054784405",
            "telephone_number": "833-688-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 FAIRFAX RD STE 2",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054784405",
            "telephone_number": "833-688-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Farrell St Ste 200",
            "address_purpose": "LOCATION",
            "city": "South Burlington",
            "state": "VT",
            "postal_code": "054036395",
            "country_code": "US",
            "telephone_number": "833-688-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHERN VERMONT DERMATOLOGY, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-29",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "NEIDER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "833-688-3376"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "VT",
            "license": "0420013164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Saint Albans, VT
• Providers in Saint Albans, VT by specialty
• Medical Specialty Clinic/Center in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.