NORTH COUNTRY MEDICAL AND WELLNESS, LLC (NPI# 1083133870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083133870 |
| Entity Type | Organization |
| Organization Name | NORTH COUNTRY MEDICAL AND WELLNESS, LLC |
| Other Organization Name | VAILAS MEDICAL CLINIC |
| Practice Address |
152 Colby St Colebrook NH 03576 |
| Mailing Address |
700 Lake Ave Ste 2 Manchester NH 03103-2734 |
| Practice Telephone | 6037315589 |
| Mailing Telephone | 6036210681 |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2019-11-25 |
| Authorized Official Name | NICHOLAS VAILAS (CEO) |
| Authorized Official Telephone | 6037315589 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Vailas Medical Clinic | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 35 Kosciuszko St, Manchester, NH 031011608 | 6036278053 | 6036274241 |
| Street Address |
152 COLBY ST |
| City | COLEBROOK |
| State | NH |
| Zip Code | 03576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336198175 | John J Fothergill | Internal Medicine | 152 Colby St, Colebrook, NH 03576-3049 | 2006-05-09 |
| 1477115053 | Keri Stiles | Nurse Practitioner | 152 Colby St, Colebrook, NH 03576-3049 | 2019-07-03 |
| 1093170169 | Kelsey Marie Skillin | Physician Assistant | 152 Colby St, Colebrook, NH 03576-3049 | 2015-12-16 |
| 1518029933 | Kathryn R Martin | Physician Assistant | 152 Colby St, Colebrook, NH 03576-3049 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255845905 | Expressmed, LLC | Physician Assistant | 152 Colby Street, Colebrook, NH 03576 | 2017-11-16 |
| 1619225331 | Sheila J. Parkhurst | Mechanotherapist | 53 Trooper Leslie Lord Mem. Hwy., Colebrook, NH 03576 | 2012-08-28 |
| 1205972874 | John Carmelo Gramuglia | Counselor | 4 Titus Hill Rd, Colebrook, NH 03576 | 2007-01-30 |
| 1205905338 | Eckerd Youth Alternatives Inc | Residential Treatment Facility, Emotionally Disturbed Children | 35 Eckerd Way, Stewartstown, NH 03576 | 2006-11-06 |
| 1386673952 | Indian Stream Health Center, Inc | General Practice | 141 Corliss Lane, Colebrook, NH 03576 | 2006-07-03 |
| 1134178775 | Rebecca M Underwood | Physical Therapist | 118 Main St Ste 6, Colebrook, NH 03576 | 2006-05-10 |
| 1861489437 | Upper Connecticut Valley Hospital Association | General Acute Care Hospital | 181 Corliss Lane, Colebrook, NH 03576 | 2005-09-29 |
| 1992204168 | Donald Murray Dickson | Pharmacist | 91 Main St, Colebrook, NH 03576 | 2018-02-02 |
| 1154735108 | Laurie Connors | Social Worker | 141 Corliss Ln, Indian Stream Health Center, Colebrook, NH 03576 | 2014-06-18 |
| 1053561001 | Darwin A Castor | Nurse Anesthetist, Certified Registered | 181 Corliss Lane, Ucvh, Colebrook, NH 03576 | 2008-09-26 |
| Find all providers in zip 03576 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306396452 | Insight Medical Group LLC | Clinic/Center | 861 Lafayette Rd Unit 6, Hampton, NH 03842-1232 | 2016-10-12 |
| 1043682438 | Acupuncture & Complementary Family Care | Clinic/Center | 359 Main St Ste 3, Farmington, NH 03835-3790 | 2015-10-24 |
| 1548582158 | Joseph Misiewicz Family Practice | Clinic/Center | 163 Daniel Webster Hwy, Meredith, NH 03253-5613 | 2010-02-23 |
| 1437339314 | Cheshire Medical Associates | Clinic/Center | 85 Emerald St, Suite 115, Keene, NH 03431-3627 | 2007-11-08 |
| 1851340954 | Cottage Hospital | Clinic/Center | 152 Woodsville Rd, Monroe, NH 03771-0180 | 2006-05-08 |
| 1457816019 | Fountains of Health | Clinic/Center | 7 Taggart Dr Ste E, Nashua, NH 03060-5591 | 2019-02-07 |
| 1831677822 | Monarch Family Medicine, LLC | Clinic/Center | 1 Oak Ridge Rd, West Lebanon, NH 03784-3121 | 2018-08-01 |
| 1497298087 | Mascoma Community Healthcare Inc | Clinic/Center | 18 Roberts Road, Canaan, NH 03741 | 2016-11-30 |
| 1255888434 | Southern New Hampshire Nurse Practitioners LLC | Clinic/Center | 428 Lafayette Rd, Suite 101, Hampton, NH 03842-2267 | 2016-09-06 |
| 1811236664 | Amoskeag Primary Care | Clinic/Center | 1650 Elm St, Suite 302, Manchester, NH 03101-1217 | 2013-02-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.