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GENESIS ELDERCARE PHYSICIAN SERVICES LLC NPI 1477576304


NPI Information

NPI: 1477576304
Provider Name: GENESIS ELDERCARE PHYSICIAN SERVICES LLC
Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
9 HAYWOOD AVE
MOUNTAIN VIEW CENTER
RUTLAND, VT
ZIP 05701
Phone: (802) 775-0007
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GENESIS ELDERCARE PHYSICIAN SERVICES LLC is a geriatric medicine internal medicine in Rutland, VT. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. GENESIS ELDERCARE PHYSICIAN SERVICES LLC NPI is 1477576304. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9 HAYWOOD AVE
MOUNTAIN VIEW CENTER
RUTLAND, VT
ZIP 05701
Phone: (802) 775-0007
Fax: (802) 775-6895

The provider's authorized official is Eric Shapiro .
The authorized official title is Vp, Controller and has the following contact phone number (410) 832-7790.

The enumeration date for this NPI number is 7/25/2006 and was last updated on 8/5/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LA2200XNurse PractitionerAdult Health101-0025776VERMONTNo
2363LG0600XNurse PractitionerGerontology101-0019819VERMONTNo
3207RG0300XInternal MedicineGeriatric MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11104819259MEDICAIDVERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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