Kristin H Pekala, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

055-0030494 Issued in VT

Practice address

331 Olcott Dr
Ste U3
White River Junction, VT 05001-9601

Phone

(802) 295-6132

Fax

(802) 295-1358

NPI assigned

Jun 16, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Dartmouth-Hitchcock Clinic

  • Internal Medicine Physician
  • Lebanon, NH
  • NPI 1548210198
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1992700884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 OLCOTT DR",
            "address_2": "STE U3",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050019601",
            "telephone_number": "802-295-6132",
            "fax_number": "802-295-1358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 OLCOTT DR",
            "address_2": "STE U3",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050019601",
            "telephone_number": "802-295-6132",
            "fax_number": "802-295-1358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEKALA",
        "first_name": "KRISTIN",
        "middle_name": "H",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055-0030494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN1243",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Palka, MSW, LMSW
• Matthew Alexander Pappas, MD
• David J Park, M.D.
• Deborah Pasho, DVM
• Beth M Pastor, RPT, HPCS
• Deborah Peltier, M.D.
• Frederick M Perkins, M.D.
• Nancy Pessia, LICSW
• Nina A Phelps
• Frank Pindyck, M.D.

• Physician Assistant in White River Junction, VT
• Providers in White River Junction, VT by specialty
• Physician Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.

Verify at the official NPI Registry.