NPIMap

Individual provider Active NPI

Kelsey Marie Skillin, PA-C

  • Physician Assistant
  • Island Pond, VT
National Provider Identifier
1093170169
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
055.0031438 Issued in VT
Practice address
82 Maple St.
Island Pond, VT 05846
Phone
(802) 723-4300
Fax
(802) 723-4544
NPI assigned
Dec 16, 2015
Last updated
Nov 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1144 NH
Physician Assistant 363A00000X 055.0031438 VT Primary

Addresses

Primary practice location

82 Maple St.
Island Pond, VT 05846

Mailing address

152 Colby St
Colebrook, NH 03576-3049
Phone (603) 331-0500

Other practice location 1

152 Colby St
Colebrook, NH 03576-3049
Phone (603) 331-0500

Other practice location 2

551 Meadow St
Littleton, NH 03561-3615
Phone (603) 761-3660

Other names 1

  • Kelsey Marie Foote Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, VT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160422000455 NH Practitioner - Physician Assistant 7012216252 Reassigns benefits to 4 organizations
I20160706000038 VT Practitioner - Physician Assistant 7012216252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians
Littleton Hospital AssociationGroup PAC ID 6901796556, 111 clinicians

Practice addresses (Care Compare)

137 Main St
Newport, VT 05855-4415
Phone (802) 995-2412

26 Cedar LN
Danville, VT 05828-9751
Phone (802) 684-2275

3 Nashua Rd
Bedford, NH 03110-5515
Phone (603) 472-6700

551 Meadow St
Littleton, NH 03561-3615
Phone (603) 761-3660

600 Saint Johnsbury Rd
Littleton, NH 03561-3442
Phone (603) 444-9000

82 Maple St
Island Pond, VT 05846
Phone (802) 723-4300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
1144NHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Counties Health Care, Inc. CurrentSince Nov 12, 2019 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Northern Counties Health Care Inc CurrentSince Nov 12, 2019 Accepting new patients
Expressmed, LLC Past Accepting new patients
Northern Counties Health Care Past Accepting new patients

Locations

3 Nashua Rd
Bedford, NH 03110
Phone (603) 472-6700

551 Meadow St
Littleton, NH 03561
Phone (603) 761-3660

111 New Hampshire Ave
Portsmouth, NH 03801

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

125 Indian Rock Rd
Windham, NH 03087
Phone (603) 890-6330

26 Cedar Ln
Danville, VT 05828
Phone (802) 684-2275

165 Sherman Dr
St Johnsbury, VT 05819
Phone (802) 748-9405

Interoperability endpoints

  • Direct secure messaging: kelsey.skillin.1@28542.direct.athenahealth.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1093170169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 COLBY ST",
            "city": "COLEBROOK",
            "state": "NH",
            "postal_code": "035763049",
            "telephone_number": "603-331-0500",
            "fax_number": "603-237-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 MAPLE ST.",
            "city": "ISLAND POND",
            "state": "VT",
            "postal_code": "05846",
            "telephone_number": "802-723-4300",
            "fax_number": "802-723-4544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "152 Colby St",
            "address_purpose": "LOCATION",
            "city": "Colebrook",
            "state": "NH",
            "postal_code": "035763049",
            "country_code": "US",
            "telephone_number": "603-331-0500",
            "fax_number": "603-237-8100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "551 Meadow St",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "NH",
            "postal_code": "035613615",
            "country_code": "US",
            "telephone_number": "603-761-3660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKILLIN",
        "first_name": "KELSEY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-16",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1144",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "FOOTE",
            "middle_name": "MARIE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Island Pond, VT

Sources for this page

Verify at the official NPI Registry.