KIRK JOSEPH WANGENSTEEN (NPI# 1104067123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104067123 |
| Entity Type | Individual |
| Full Name | KIRK JOSEPH WANGENSTEEN |
| Credential | M.D., PH.D. |
| Practice Address |
111 Colchester Ave Burlington VT 05401-1473 |
| Mailing Address |
3400 Civic Center Blvd 7th Flr South Philadelphia PA 19104 |
| Practice Telephone | 8028474953 |
| Practice Fax Number | 8028475927 |
| Mailing Telephone | 2153498222 |
| Mailing Fax Number | 2156626530 |
| Enumeration Date | 2009-03-20 |
| Last Update Date | 2016-05-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
MD457451 | PA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | VT | Student, Health Care |
| Street Address |
111 COLCHESTER AVE |
| City | BURLINGTON |
| State | VT |
| Zip Code | 05401-1473 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376548354 | Richard A. Boothby | Obstetrics & Gynecology | 111 Colchester Ave, Burlington, VT 05401-1473 | 2005-06-16 |
| 1992304513 | Jennifer Smith Henry | Registered Nurse | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-10-23 |
| 1922606581 | Jessica Fischer | Dietitian, Registered | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-10-15 |
| 1922615855 | Emily R Pichler | Psychologist | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-09-24 |
| 1285257618 | Nadia Stefania Fletcher | Registered Nurse | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-05-20 |
| 1538781380 | Jeffrey Raymond Gonzalez | Pharmacist | 111 Colchester Ave, Mailstop 272ba1, Burlington, VT 05401 | 2020-05-15 |
| 1588292874 | Breshawn Best | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-31 |
| 1528696853 | Nektarios Konstantinopoulos | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-31 |
| 1457989071 | Siddique Tanzeem Akram | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-30 |
| 1184252124 | Steven Direda II | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626748 | John Henry Priester Jr. | Student in an Organized Health Care Education/Training Program | University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT 05401 | 2020-03-27 |
| 1730649054 | Parisa Heidari | Student in an Organized Health Care Education/Training Program | Uvmmc 111 Colchester Avenue, Burlington, VT 05401 | 2019-03-22 |
| 1689141988 | No Diet Dietitian, LLC | Dietitian, Registered | 163 Bayberry Circle #204, Burlington, VT 05401 | 2018-10-25 |
| 1073097267 | Katherine Dwyer | Physical Therapist | 128 Lakeside Ave, Burlington, Vt, 05401, Burlington, VT 05401 | 2018-09-24 |
| 1710469481 | Nicholas A Fredette | Nurse Practitioner | 28 S. Williams St., Burlington, VT 05401 | 2018-08-30 |
| 1760987473 | Tyler Fanning | Psychiatry & Neurology | Uvmmv 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-26 |
| 1356845416 | Rachel Carlson | Student in an Organized Health Care Education/Training Program | Uvmmc, 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-22 |
| 1487152096 | Garnet Transport Medicine, LLC | Ambulance | 70 S Winooski Ave Ste 255, Burlington, VT 05401 | 2018-01-29 |
| 1689172660 | Valerie Goldberg | Dietitian, Registered | 163 Bayberry Circle Apt 204, Burlington, VT 05401 | 2018-01-25 |
| 1548774235 | Emily R Day | Physical Therapist | 160 Flynn Avenue, Burlington, VT 05401 | 2017-11-17 |
| Find all providers in zip 05401 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699069252 | Laurie Grossberg | Internal Medicine | Lahey Hospital and Medical Center 41 Mall Rd, Burlington, MA 01805-5400 | 2011-06-01 |
| 1578798591 | Rohini Reddy Vanga | Internal Medicine | 1248 Huffman Mill Rd Ste 201, Burlington, NC 27215-8700 | 2009-05-19 |
| 1912197054 | S. Peter Gibb | Internal Medicine | Lahey Clinic Foundation, 41 Mall Road, Burlington, MA 01805-0001 | 2007-07-25 |
| 1396818100 | Richard Sandford Zubarik | Internal Medicine | Smith 212-fletcher Allen Health Care, Colchester Avenue, Burlington, VT 05001 | 2006-11-17 |
| 1316455223 | Moses Cone Physician Services, Inc. | Internal Medicine | 1248 Huffman Mill Rd Ste 201, Burlington, NC 27215-8700 | 2018-01-12 |
| 1700315082 | Alexandra Pogosky | Internal Medicine | 41 Mall Rd, Burlington, MA 01805-0001 | 2017-06-08 |
| 1659766764 | Jason David Heffley | Internal Medicine | 111 Colchester Ave, Burlington, VT 05401-1473 | 2015-04-06 |
| 1811301070 | Jane Roberts | Internal Medicine | 111 Colchester Ave, Burlington, VT 05401-1473 | 2014-06-16 |
| 1841558533 | Joseph David Frasca | Internal Medicine | 111 Colchester Ave, Burlington, VT 05401-1473 | 2012-05-01 |
| 1942566732 | Anna Leszczynski | Internal Medicine | 41 Mall Rd, Burlington, MA 01805-0001 | 2012-04-05 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 05401 |
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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.