DR. PETER DOUGLAS GIBBONS (NPI# 1639239312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639239312 |
Entity Type | Individual |
Full Name | DR. PETER DOUGLAS GIBBONS |
Credential | MD |
Practice Address |
17 Belmont Ave Brattleboro VT 05301 |
Mailing Address |
17 Belmont Ave. Brattleboro VT 05301 |
Practice Telephone | 8022570115 |
Practice Fax Number | 8022578849 |
Mailing Telephone | 8022578360 |
Mailing Fax Number | 8022578849 |
Enumeration Date | 2006-12-11 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
042-0004180 | VT | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
VT | 0004779 | 05 | |
VT | BLUE SHIELD | 00004779 | 01 |
VT | COMMERCIAL | 03-0239725 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639586761 | Peter A Gibbons | Pharmacist | 2680 S Lincoln Ave, Jerome, ID 83338-6128 | 2014-07-21 |
Street Address |
17 BELMONT AVE |
City | BRATTLEBORO |
State | VT |
Zip Code | 05301 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306849708 | Brattleboro Memorial Hospital | Pediatrics | 17 Belmont Ave, Brattleboro, VT 05301-3498 | 2005-05-31 |
1750910931 | Clayton Michael Mcginnis | Nurse Practitioner | 17 Belmont Ave, Brattleboro, VT 05301-7601 | 2020-04-08 |
1760992002 | Hannah Cressy | Nurse Practitioner | 17 Belmont Ave, Brattleboro, VT 05301-7601 | 2017-09-30 |
1518418201 | Angela P. Miller | Nurse Practitioner | 17 Belmont Ave, Brattleboro, VT 05301-7601 | 2016-10-18 |
1740644236 | Anne Mccandless | Registered Nurse | 17 Belmont Ave, Brattleboro, VT 05301-7601 | 2016-04-11 |
1700273133 | Laurie Kuralt | Nurse Practitioner | 17 Belmont Ave, Brattleboro, VT 05301-7601 | 2015-04-23 |
1053704924 | Samantha Bellamy | Radiologic Technologist | 17 Belmont Ave, Brattleboro, VT 05301-7601 | 2015-03-16 |
1235558081 | Jennifer Black | Obstetrics & Gynecology | 17 Belmont Ave, Brattleboro, VT 05301-7601 | 2014-04-09 |
1013216324 | Tatyana Pankratova | Internal Medicine | 17 Belmont Ave, Brattleboro, VT 05301-7601 | 2011-03-25 |
1174843155 | Elizabeth A. Mclarney, M.d., P.C. | Orthopaedic Surgery | 17 Belmont Ave, Brattleboro, VT 05301-7601 | 2010-06-02 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013575372 | Roberta M. White | Psychologist | 72 Whetstone Rd, Brattleboro, VT 05301 | 2019-06-03 |
1225526940 | Audrey Johnston | Nurse Practitioner | Brattleboro Family Medicine, 53 Fairview Street, Brattleboro, VT 05301 | 2018-04-27 |
1811349582 | Jillian Barney | Physician Assistant | 17 Belmont Ave Richards Building (1st Floor), Barttleboro, VT 05301 | 2016-07-06 |
1326413899 | Gabriella Neacsu Katz | Nurse Practitioner | 1860 Weatherhead Hollow Rd, Guilford, VT 05301 | 2015-12-09 |
1942608914 | Kathryn Peterson | Registered Nurse | 105 Winter St Apt 2, Brattleboro, VT 05301 | 2014-12-08 |
1558762823 | Saryn T Lauzon | Registered Nurse | 2 Maplewood Drive, Brattleboro, VT 05301 | 2014-09-05 |
1912248691 | Robert Joseph Stack | Counselor | 1 Linden Street, Brattleboro, VT 05301 | 2013-03-06 |
1053651760 | Christopher M. Deszynski | Naturopath | 73 Main St Ste 4, Brattleboro, VT 05301 | 2013-02-18 |
1518236355 | Christine Hamrin | Licensed Practical Nurse | 54 Spruce Street, Brattleboro, VT 05301 | 2011-12-23 |
1881924934 | Margrit C. Mikulis | Naturopath | 147 Orchard St, Brattleboro, VT 05301 | 2010-01-12 |
Find all providers in zip 05301 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700011673 | Mariusz Paluch | Radiology | 17 Belmont Ave, Brattleboro, VT 05301-3498 | 2009-05-21 |
1285774307 | Windham Radiology Associates Inc | Radiology | 17 Belmont Ave, Brattleboro, VT 05301-6613 | 2007-02-07 |
1013953793 | Edward F. Elliott Jr. | Radiology | 17 Belmont Ave, Brattleboro, VT 05301-6613 | 2006-06-21 |
1063469419 | Walter Wagenknecht | Radiology | 17 Belmont Ave, Brattleboro, VT 05301-7601 | 2006-05-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457643272 | Matthew G. Geeslin | Radiology | 111 Colchester Ave Dept Of, Burlington, VT 05401-1473 | 2011-05-12 |
1871758201 | G. Kenneth Dehart Jr. | Radiology | 1298 Savage Point Rd., Box 126, North Hero, VT 05474-0126 | 2008-07-24 |
1477740843 | Raymond L Horwitz | Radiology | 47 Rogues Ridge Rd., Winhall, VT 05340 | 2007-10-01 |
1932286523 | Charles Nicholas Pappas | Radiology | 609 Stockbridge Rd, Charlotte, VT 05445-9361 | 2006-11-01 |
1659463578 | James Russell Chandler | Radiology | 1 Fisher Road, Central Vermont Hospital, Barre, VT 05401 | 2006-09-28 |
1467499053 | Jane C Primm | Radiology | 111 Colchester Ave, Acc-2nd Fl, Fletcher Allen Health Care, Burlington, VT 05401-1473 | 2006-06-01 |
1356328975 | Michael A Nissenbaum | Radiology | 333 Wade Pasture Rd, Stowe, VT 05672-5384 | 2005-12-23 |
1679042196 | Matthew Maya | Radiology | 163 Veterans Dr, White River Junction, VT 05009-0001 | 2018-11-14 |
1881081743 | Aaron Dewald | Radiology | 111 Colchester Ave, Burlington, VT 05401-1473 | 2015-04-17 |
1043630510 | Ryan Wolfe | Radiology | 111 Colchester Ave, Burlington, VT 05401-1473 | 2014-04-23 |
Find all providers with the same taxonomy |
City | BRATTLEBORO |
Zip Code | 05301 |
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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.