| Nicole Clark, | |
|
130 Fisher Rd Unit 1, Berlin, VT 05602-8132 | |
| (802) 225-1743 | |
| Not Available |
| Full Name | Nicole Clark |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 6 Years |
| Location | 130 Fisher Rd Unit 1, Berlin, Vermont |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720606130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 055-0031682 (Vermont) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Central Vermont Medical Center | Berlin, VT | Hospital |
| University Of Vermont Medical Center | Burlington, VT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Central Vermont Medical Center Inc | 9335138817 | 233 |
| Entity Name | Central Vermont Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023028784 PECOS PAC ID: 9335138817 Enrollment ID: O20051220000393 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Clark, 412 Bunker Hill Rd, Everett, PA 15537-5539 Ph: Not Available | Nicole Clark, 130 Fisher Rd Unit 1, Berlin, VT 05602-8132 Ph: (802) 225-1743 |
Mr. Dominic Carroll Ayer, M.S. PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1311 Barre-montpelier Road, Suite 200, Berlin, VT 05602 Phone: 802-371-4239 |
Jacqueline Gallagher, PA Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 130 Fisher Rd, Emergency Dept, Berlin, VT 05602 Phone: 802-371-4365 Fax: 802-371-4481 |
Robert R Davidson, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 130 Fisher Rd, Berlin, VT 05602 Phone: 802-225-7000 |
Kristen Kivlen, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 130 Fisher Rd, Berlin, VT 05602 Phone: 802-371-4100 Fax: 301-797-4234 |
Scott Alan Small, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 130 Fisher Rd, Bld. A, Suite 2-2, Berlin, VT 05602 Phone: 802-229-2663 Fax: 802-229-6645 |
Patricia Ann Driscoll, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 246 Granger Rd, Suite 2, Berlin, VT 05602 Phone: 802-225-5810 Fax: 802-371-4821 |
William Bond Burton, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 130 Fisher Rd, Berlin, VT 05602 Phone: 802-371-4100 |