Individual provider Active NPI

Kathleen Gorman, NNP

  • Neonatal Nurse Practitioner
  • Burlington, VT
National Provider Identifier
1114984093
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
101-0134511 Issued in VT
Practice address
111 Colchester Ave
Burlington, VT 05401-1473
Phone
(802) 847-0000
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X 096168 AZ
Neonatal Nurse Practitioner 363LN0000X 101-0134511 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Burlington, VT 05401-1473

Mailing address

21909 N 120TH Ave
Sun City, AZ 85373-5672
Phone (602) 549-3443

Other practice location 1

901 E Willetta St
Ste. 2503
Phoenix, AZ 85006-2727
Phone (602) 239-5166

Other practice location 2

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

Other practice location 3

1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kgorman124191@ValleyHealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, OH, VT, AZ, MD5 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20160209001198 VA Practitioner - Nurse Practitioner 0547496945 Reassigns benefits to 1 organization
I20210819000966 OH Practitioner - Nurse Practitioner 0547496945 Reassigns benefits to 2 organizations
I20220810002572 VT Practitioner - Nurse Practitioner 0547496945 Reassigns benefits to 1 organization
I20251021001872 AZ Practitioner - Nurse Practitioner 0547496945 Reassigns benefits to 1 organization
I20260406003257 MD Practitioner - Pediatric Medicine 0547496945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3585 Washington Blvd
Halethorpe, MD 21227-1668

5301 E Grant Rd
Tucson, AZ 85712-2805

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
101-0134511VTMDNeonatal Nurse Practitioner
096168AZMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians - North, LLC CurrentSince Aug 22, 2021 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Winchester Medical Center Current Accepting new patients
Mercy Health Physicians-North LLC CurrentSince Aug 22, 2021 Accepting new patients
Winchester Medical Center CurrentSince Dec 5, 2015 Accepting new patients
Winchester Medical Center CurrentSince Dec 5, 2015 Accepting new patients
Winchester Medical Center Current Accepting new patients
Shenandoah Valley Pathology Laboratories Inc Current Accepting new patients
TMC Medical Network CurrentSince Oct 27, 2025 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Arizona OB GYN Affiliates PC Past Accepting new patients

Locations

2380 N Ferguson Ave
Ste 104
Tucson, AZ 85712
Phone (520) 324-1010

5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

2213 Cherry St
Toledo, OH 43608
Phone (419) 251-4283

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

Interoperability endpoints

  • Direct secure messaging: kgorman881995@direct.bsmhealth.org
  • Direct secure messaging: kgorman467012@direct.uvmhealth.org
  • Direct secure messaging: kgorman124191@valleyhealth.direct-ci.com

Organizations & group practices 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1114984093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21909 N 120TH AVE",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853735672",
            "telephone_number": "602-549-3443",
            "fax_number": "623-492-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 E Willetta St",
            "address_2": "Ste. 2503",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062727",
            "country_code": "US",
            "telephone_number": "602-239-5166",
            "fax_number": "602-239-2307",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2315 Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172201",
            "country_code": "US",
            "telephone_number": "916-734-2011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1840 Amherst St",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "VA",
            "postal_code": "226012808",
            "country_code": "US",
            "telephone_number": "540-536-8000",
            "fax_number": "540-536-7780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "KATHLEEN",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "AZ",
            "license": "096168",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "VT",
            "license": "101-0134511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgorman124191@ValleyHealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1840 Amherst St",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226012808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.