Kelley Collier
Individual provider Active NPI Family Medicine Physician · South Burlington, VT
NPI 1124524434 · NPPES record last updated Sep 2, 2021
Key facts
- NPI
- 1124524434
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 042-0015444 (VT)
- Practice address
- 3 Timber LN
South Burlington, VT 05403-7205 - Phone
- (802) 847-8500
- NPI assigned
- Apr 4, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Vermont College of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University of Vermont Medical Center Inc
Practice addresses (Care Compare)
111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000
Hospital & facility affiliations
- Bayada Home Health Care, Inc.
- Univ. of Vermont - Fletcher Allen Health Care
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210909002336 | VT | Practitioner - Family Practice |
0941559926 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0015444 | VT | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Vermont Medical Center Inc | Family Medicine | Current |
Accepting new patients |
| Fletcher Allen Health Care Inc | Past |
Accepting new patients |
Locations
111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415
1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531
3 Timber Ln
South Burlington, VT 05403
Phone (802) 847-3339
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 042-0015444 | VT | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 042-0015444 | VT | Yes |
Addresses
Primary practice location
3 Timber LN
South Burlington, VT 05403-7205
Mailing address
3055 Roslyn St Unit 100
Denver, CO 80238-3324
Other practice location 1
111 Colchester Ave
Burlington, VT 05401-1473
Phone (808) 847-7911
Other practice location 2
3055 Roslyn St Unit 100
Denver, CO 80238-3324
Phone (720) 553-2696
NPI Registry JSON
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630540800000",
"number": "1124524434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3055 ROSLYN ST UNIT 100",
"city": "DENVER",
"state": "CO",
"postal_code": "802383324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 TIMBER LN",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054037205",
"telephone_number": "802-847-8500"
}
],
"practiceLocations": [
{
"address_1": "111 Colchester Ave",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "VT",
"postal_code": "054011473",
"country_code": "US",
"telephone_number": "808-847-7911",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3055 Roslyn St Unit 100",
"address_purpose": "LOCATION",
"city": "Denver",
"state": "CO",
"postal_code": "802383324",
"country_code": "US",
"telephone_number": "720-553-2696",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLLIER",
"first_name": "KELLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-04",
"last_updated": "2021-09-02",
"certification_date": "2021-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "VT",
"license": "042-0015444",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VT",
"license": "042-0015444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Burlington, VT
- Clodagh Coghlan
- Colbrook Nutrition Counseling LLC
- Heather Elizabeth Colgan
- Mary Collett
- David P Collette
- James P Collins
- Julia Collins
- Michaela Columbia
- Community Health Centers of Burlington Inc
- Concentra Health Services, Inc.
All providers in South Burlington, VT · Family Medicine Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.