STACEY A MCKENNA (NPI# 1639281272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1639281272 |
Entity Type | Individual |
Full Name | STACEY A MCKENNA |
Credential | AA |
Practice Address |
111 Colchester Ave Burlington VT 05401-1473 |
Practice Telephone | 8028472415 |
Practice Fax Number | 8028475324 |
Mailing Telephone | 8028472415 |
Mailing Fax Number | 8028475324 |
Enumeration Date | 2006-08-31 |
Last Update Date | 2015-04-06 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 367H00000X | Anesthesiologist Assistant | 135.0000038 | VT | Physician Assistants & Advanced Practice Nursing Providers |
N | 367H00000X | Anesthesiologist Assistant | 4646 | GA | Physician Assistants & Advanced Practice Nursing Providers |
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 | 367H00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Anesthesiologist Assistant |
An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962984047 | Katie Elizabeth Noel | Anesthesiologist Assistant | 111 Colchester Ave, Burlington, VT 05401-1473 | 2018-09-05 |
1730558396 | Sara J. Church | Anesthesiologist Assistant | 111 Colchester Ave., Uvm Medical Center - Dept. of Anesthesiology, Burlington, VT 05401 | 2015-09-24 |
1134529340 | Matthew Peter Fazio | Anesthesiologist Assistant | 111 Colchester Ave., Uvm Mc - Anesthesiology, Burlington, VT 05401 | 2014-08-26 |
1285040352 | Jay Benjamin Ginns | Anesthesiologist Assistant | 111 Colchester Ave, Burlington, VT 05401-1473 | 2014-07-09 |
1396089553 | Paul R Dunn | Anesthesiologist Assistant | 111 Colchester Ave, Burlington, VT 05401-1473 | 2012-11-12 |
1720390321 | Luke J Eaton | Anesthesiologist Assistant | 111 Colchester Ave, Burlington, VT 05401-1473 | 2010-07-12 |
1609804608 | Caroline V. Horn | Anesthesiologist Assistant | 111 Colchester Ave., Uvm Medical Center, Dept. of Anesthesiology, Burlington, VT 05401 | 2006-06-29 |
1629005608 | Nathan Horn | Anesthesiologist Assistant | 111 Colchester Ave, Burlington, VT 05401-1473 | 2006-06-27 |
1659314631 | Karen Clark | Anesthesiologist Assistant | 111 Colchester Ave, Fahc-wp2, Burlington, VT 05401-1473 | 2006-06-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114530029 | Kelsey Buran | Anesthesiologist Assistant | 100 Hospital Dr, Bennington, VT 05201-5004 | 2020-08-29 |
1619453958 | Mary Campbell | Anesthesiologist Assistant | 100 Hospital Dr, Bennington, VT 05201-5004 | 2018-07-18 |
1932621570 | Cody Holloway | Anesthesiologist Assistant | 100 Hospital Dr, Bennington, VT 05201-5004 | 2017-07-15 |
1396126207 | Kimberley Monnet | Anesthesiologist Assistant | 100 Hospital Dr, Bennington, VT 05201-5004 | 2015-06-16 |
1700217015 | Suela Hysenaj | Anesthesiologist Assistant | 100 Hospital Dr, Bennington, VT 05201-5004 | 2013-12-12 |
1881722031 | Timothy Scott Snyder | Anesthesiologist Assistant | 100 Hospital Dr, Bennington, VT 05201-5004 | 2007-03-01 |
1821171794 | Gary Moelich | Anesthesiologist Assistant | 100 Hospital Drive, Bennington, VT 05201 | 2006-10-23 |
1962514406 | John Calvin Gower | Anesthesiologist Assistant | 100 Hospital Dr, Bennington, VT 05201-5004 | 2006-08-31 |
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.