| Green Mountain Internal Medicine Plc | |
|
28 S Williams St Burlington VT 05401-3486 | |
| (802) 864-7080 | |
| Not Available |
| Full Name | Green Mountain Internal Medicine Plc |
|---|---|
| Speciality | Internal Medicine |
| Location | 28 S Williams St, Burlington, Vermont |
| Authorized Official Name and Position | Deborah Caise (OFFICE MANAGER) |
| Authorized Official Contact | 8028647080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Mountain Internal Medicine Plc 28 S Williams St Burlington VT 05401-3486 Ph: (802) 864-7080 | Green Mountain Internal Medicine Plc 28 S Williams St Burlington VT 05401-3486 Ph: (802) 864-7080 |
| NPI Number | 1558885988 |
|---|---|
| Provider Enumeration Date | 07/27/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 3779859772 |
|---|---|
| Medicare Enrollment ID | O20171018003152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558885988 | NPI | - | NPPES |
| 211-49643 | Other | VT | BLUE CROSS BLUE SHIELD |
| OVN2388 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 042-0010014 (Vermont) | Primary |
| Provider Name | Melissa K Brandes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265468318 PECOS PAC ID: 0648214296 Enrollment ID: I20101004000917 |
| Provider Name | Melissa S Barrup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447520499 PECOS PAC ID: 5698939460 Enrollment ID: I20120606000475 |
| Provider Name | Sarah D Nadeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407120603 PECOS PAC ID: 5597929059 Enrollment ID: I20120613000152 |
| Provider Name | Nicholas A Fredette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710469481 PECOS PAC ID: 4183961253 Enrollment ID: I20190128001559 |
| Provider Name | Brianna Kristine Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366051690 PECOS PAC ID: 7416345616 Enrollment ID: I20211020001761 |
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State Of Vermont Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 108 Cherry St, Burlington, VT 05401 Phone: 802-863-7338 Fax: 802-863-7635 | |
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