=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245366277
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VERMONT PHYSICIANS CLINIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 69 ALLEN ST SUITE 10
-----------------------------------------------------
City | RUTLAND
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05701-4564
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-786-9063
-----------------------------------------------------
Fax | 802-747-4532
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 69 ALLEN ST SUITE 10
-----------------------------------------------------
City | RUTLAND
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05701-4564
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-786-9063
-----------------------------------------------------
Fax | 802-747-4532
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. KURT ANDREW KRUPNICK
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 802-786-9063
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------