GENESIS ELDERCARE PHYSICIAN SERVICES LLC (NPI# 1477576304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477576304 |
| Entity Type | Organization |
| Organization Name | GENESIS ELDERCARE PHYSICIAN SERVICES LLC |
| Practice Address |
9 Haywood Ave Mountain View Center Rutland VT 05701 |
| Mailing Address |
Po Box 62946 Baltimore MD 21264-2946 |
| Practice Telephone | 8027750007 |
| Practice Fax Number | 8027756895 |
| Mailing Telephone | 4104947607 |
| Mailing Fax Number | 6109257387 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2019-08-05 |
| Authorized Official Name | MR. ERIC SHAPIRO (VP, CONTROLLER) |
| Authorized Official Telephone | 4108327790 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
101-0025776 | VT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
101-0019819 | VT | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 1104819259 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801215041 | Genesis Eldercare Physician Services LLC | Family Medicine | 835 Tenderfoot Hill Rd # T, Colorado Springs, CO 80906 | 2014-04-15 |
| 1033535828 | Genesis Eldercare Physician Services LLC | Nurse Practitioner | 16605 Chestnut Glen Pl, Louisville, KY 40245 | 2014-03-17 |
| 1609180926 | Genesis Eldercare Physician Services LLC | Family Medicine | 6508 Deer Pointe Dr Ste A, Salisbury, MD 21804 | 2010-07-28 |
| 1326148107 | Genesis Eldercare Physician Services LLC | Skilled Nursing Facility | 14233 Alta Oaks Dr, Rockville, MD 20850-7413 | 2006-09-22 |
| 1699710202 | Genesis Eldercare Physician Services LLC | Internal Medicine | 11 Dairy Ln, Fredericksburg, VA 22405-2663 | 2006-06-18 |
| 1881635183 | Genesis Eldercare Physician Services LLC | Internal Medicine | 6508 Deer Pointe Dr, Suite A, Salisbury, MD 21804 | 2006-06-09 |
| 1104819259 | Genesis Eldercare Physician Services LLC | Internal Medicine | 464 Main St, Heritage Hall East, Agawam, MA 01001 | 2005-08-24 |
| 1164415196 | Genesis Eldercare Physician Services LLC | Internal Medicine | 1 Emerson Dr, Kimberly Hall North, Windsor, CT 06095 | 2005-08-24 |
| 1699280511 | Genesis Eldercare Physician Services LLC | Internal Medicine | 515 Fairmount Ave, Towson, MD 21286 | 2017-12-14 |
| 1548615313 | Genesis Eldercare Physician Services LLC | Internal Medicine | 7900 Constitution Ave Ne, Albuquerque, NM 87110 | 2016-04-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | GENESIS ELDERCARE PHYSICIAN SERVICES LLC | 101 E State St, Kennett Sq, PA 19348-3109 |
| Street Address |
9 HAYWOOD AVE MOUNTAIN VIEW CENTER |
| City | RUTLAND |
| State | VT |
| Zip Code | 05701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760457212 | Joan M Attig | Nurse Practitioner | 9 Haywood Ave, Mountain View Center, Rutland, VT 05701-4832 | 2006-02-20 |
| 1376168062 | Erin Mangene | Speech-Language Pathologist | 9 Haywood Ave, Rutland, VT 05701-4832 | 2020-06-09 |
| 1154957934 | Carolyn Elizabeth Kane | Occupational Therapist | 9 Haywood Ave, Rutland, VT 05701-4832 | 2020-03-12 |
| 1265081905 | Anne-marie Ruth Provencal | Occupational Therapist | 9 Haywood Ave, Rutland, VT 05701-4832 | 2019-09-05 |
| 1154817476 | Alexandra Desrochers | Speech-Language Pathologist | 9 Haywood Ave, Rutland, VT 05701-4832 | 2018-07-10 |
| 1013413244 | Meghan Mcnierney | Occupational Therapist | 9 Haywood Ave, Rutland, VT 05701-4832 | 2018-04-05 |
| 1154826063 | Keri-lynn Marie Yonika | Occupational Therapy Assistant | 9 Haywood Ave, Rutland, VT 05701-4832 | 2018-03-25 |
| 1437659828 | Kathryn June Smolen | Student in an Organized Health Care Education/Training Program | 9 Haywood Ave, Rutland, VT 05701-4832 | 2018-02-13 |
| 1427570035 | Leslie Bardin | Occupational Therapist | 9 Haywood Ave, Rutland, VT 05701-4832 | 2017-07-14 |
| 1679001879 | William F Vandercar | Physical Therapist | 9 Haywood Ave, Rutland, VT 05701-4832 | 2017-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639721186 | All Dimensions Primary Care Pllc | Physician Assistant | 92 Allen Street, Rutland, VT 05701 | 2019-07-15 |
| 1962809053 | Laura Kalinen Laprise | Nurse Practitioner | Rutland Community Health Center, 215 Stratton Road, Rutland, VT 05701 | 2014-12-04 |
| 1962818781 | Andrea Louise Welch | Pharmacist | 1 Rutland Shopping Plaza, Rutland, VT 05701 | 2014-07-02 |
| 1396158903 | Gwendolyn Koenig | Counselor | 78 South Main St., Rutland, VT 05701 | 2014-06-11 |
| 1194088195 | Marcie Bouchard | Early Intervention Provider Agency | 24a East Street, Rutland, VT 05701 | 2012-06-25 |
| 1790047009 | Pamela Lenoci | Massage Therapist | 196 Joshua Place, Rutland, VT 05701 | 2012-06-12 |
| 1528339959 | Deborah E. Boston | Social Worker | 128 Merchants Row Ste 510, Rutland, VT 05701 | 2012-01-17 |
| 1235431834 | Alicia Marie Riesterer | Occupational Therapy Assistant | 46 Nichols St., Rutland Healthcare and Rehabilitation Center, Rutland, VT 05701 | 2010-12-02 |
| 1497085401 | Lauren Ann Lasante | Counselor | 198 N Main St Ste C-5, Rutland, VT 05701 | 2010-01-14 |
| 1568692515 | Steven C. Duboff, Dmd, PC | Dentist | 198 North Main St, Rutland, VT 05701 | 2009-07-23 |
| Find all providers in zip 05701 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| 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. |
| 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 |
|---|---|---|---|---|
| 1376639021 | Dorothy Fisher | Internal Medicine | 15 Rustic Drive, Essex Jct., VT 05452 | 2006-10-04 |
| 1992142939 | Alexandra L Messerli | Internal Medicine | 353 Blair Park Rd, Williston, VT 05495-7530 | 2013-05-31 |
| 1801005632 | Michael Andrew Lamantia | Internal Medicine | 792 College Pkwy, Uvm Medical Center - Div. of Internal Med. & Geriatrics, Colchester, VT 05446-3052 | 2007-05-21 |
| 1508949553 | John H Wasson | Internal Medicine | 215 N Main St, White River Junction, VT 05009-0001 | 2006-10-23 |
| 1427158989 | Zail Suzanne Berry | Internal Medicine | 111 Colchester Ave, Burlington, VT 05401-1473 | 2006-09-25 |
| 1396849972 | Christopher David Nice | Internal Medicine | 215 N Main St, Va, White River Junction, VT 05001-3833 | 2006-09-12 |
| 1679589550 | Thomas Walter Lewis | Internal Medicine | 19 Belmont Ave, Suite 105, Brattleboro, VT 05301-7109 | 2006-07-31 |
| 1780608588 | Robert Karp | Internal Medicine | 1 S Prospect St, Burlington, VT 05401-3456 | 2006-07-26 |
| 1700854379 | Richard M Orlan | Internal Medicine | 19 Belmont Ave, Suite 1201, Brattleboro, VT 05301-7109 | 2006-03-09 |
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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.