Individual provider Active NPI

Lucy McKeon, MD

  • Family Medicine Physician
  • Brandon, VT
National Provider Identifier
1326034356
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0420008138 Issued in VT
Practice address
61 Court Dr
Brandon, VT 05733-8407
Phone
(802) 247-3755
NPI assigned
Sep 26, 2005
Last updated
Mar 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0420008138 VT Primary

Addresses

Primary practice location

61 Court Dr
Brandon, VT 05733-8407

Mailing address

61 Court Dr
Brandon, VT 05733-8407
Phone (802) 247-3755

Other identifiers 1

IdentifierTypeStateIssuer
0009526MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0420008138VTMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1326034356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 COURT DR",
            "city": "BRANDON",
            "state": "VT",
            "postal_code": "057338407",
            "telephone_number": "802-247-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 COURT DR",
            "city": "BRANDON",
            "state": "VT",
            "postal_code": "057338407",
            "telephone_number": "802-247-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEON",
        "first_name": "LUCY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "0420008138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009526",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.