Vernon Integrative Medical Group, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

80587 Issued in MA

Legal business name

VERNON INTEGRATIVE MEDICAL GROUP, LLC

Practice address

141 Massasoit Rd
Worcester, MA 01604-3318

Phone

(508) 754-9950

Fax

(508) 754-2592

NPI assigned

Jul 31, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Jon Trister, MDNPI 1639131352

Title

Owner

Phone

(508) 754-9950

Specialties & licenses 1

Addresses

Other identifiers 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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2463/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jon Trister, M.D.

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1639131352
  NPD Authorized official
• Jolanta Sledzik, FNP-C

  • Family Nurse Practitioner
  • Worcester, MA
  • NPI 1699476036
  NPD

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1972935070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 MASSASOIT RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016043318",
            "telephone_number": "508-754-9950",
            "fax_number": "508-754-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MASSASOIT RD",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016043318",
            "telephone_number": "508-754-9950",
            "fax_number": "508-754-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNON INTEGRATIVE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "TRISTER",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-754-9950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "80587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3144941",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura C Verducci, SLP
• Ashish Verma, MD, MRCP
• Hersh Verma, CLINICIAN
• Vernon Hill Pediatric Dentistry
• Vernon Integrative Medical Group LLC
• Vernon Women Health Services LLC
• Juan P. Vernon, MD
• Vero Health Xvi, LLC (Vero Health & Rehab of Worcester)
• Aida Verrastro, M.A.
• Christine Elizabeth Veshi

• Internal Medicine Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.