Keely Sullivan, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

101.0135179 Issued in VT

Practice address

111 Colchester Ave
Burlington, VT 05401-1473

Phone

(518) 569-2886

NPI assigned

Feb 15, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Keely Sullivan Professional name

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

University of Vermont Medical Center IncGroup PAC ID 3779491071, 1,208 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003
• The University of Vermont Health Network - Champl Hospital, Plattsburgh, NY, CCN 330250
• Adirondack Medical Center - Saranac Lake Hospital, Saranac Lake, NY, CCN 330079
• The University of Vermont Health Network-Alice Hy Hospital, Malone, NY, CCN 331321
• Northwestern Medical Center Inc Hospital, Saint Albans, VT, CCN 470024

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: ksullivan15853@direct.uvmhealth.org

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.

• University of Vermont Medical Center Inc

  • Internal Medicine Physician
  • Burlington, VT
  • NPI 1659309615
  Medicare reassignment Care Compare group

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

• Northwestern Medical Center Inc

  • General Acute Care Hospital
  • Saint Albans, VT
  • NPI 1386689875
  Care Compare affiliation
• University of Vermont Medical Center Inc

  • General Acute Care Hospital
  • Burlington, VT
  • NPI 1568419976
  Care Compare affiliation
• Adirondack Medical Center

  • General Acute Care Hospital
  • Saranac Lake, NY
  • NPI 1699709576
  Care Compare affiliation
• Adirondack Medical Center

  • General Acute Care Hospital
  • Saranac Lake, NY
  • NPI 1851601108
  Care Compare affiliation
• Alice Hyde Medical Center

  • Critical Access Hospital
  • Malone, NY
  • NPI 1114954682
  Care Compare affiliation
• Champlain Valley Physicians Hospital Medical Center

  • General Acute Care Hospital
  • Plattsburgh, NY
  • NPI 1033270699
  Care Compare affiliation

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

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1245985688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 QUARRY LN",
            "city": "SWANTON",
            "state": "VT",
            "postal_code": "054888946",
            "telephone_number": "518-569-2886"
        },
        {
            "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": "518-569-2886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KEELY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VT",
            "license": "101.0135179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEELY",
            "last_name": "SULLIVAN",
            "prefix": "MS.",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Alison Sullivan
• Chance Sullivan, MD
• Jeanne Sullivan, LICSW
• Jill Ann Sullivan, RD
• Jillian Sarah Sullivan, MD
• Mariel Sullivan
• Nicole Sullivan
• Robin Ann Sumner
• Samantha Mei Sun
• Sunrise Counseling and Wellness

• Acute Care Nurse Practitioner in Burlington, VT
• Providers in Burlington, VT by specialty
• Acute Care Nurse Practitioner in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.