Keith J Breasure, MSN,NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

101.0096152 Issued in VT

Practice address

130 Fisher Rd
Berlin, VT 05602-9516

Phone

(802) 371-4316

Fax

(802) 371-4579

NPI assigned

May 10, 2006

Last updated

Feb 12, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1326097767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "address_2": "ATT: CVMC FINANCE DEPT",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-371-4316",
            "fax_number": "802-371-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FISHER RD",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056029516",
            "telephone_number": "802-371-4316",
            "fax_number": "802-371-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREASURE",
        "first_name": "KEITH",
        "middle_name": "J",
        "credential": "MSN,NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG0000383",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101.0096152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Naomi Black, MD
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• Glenn Bomberger, LADC
• Courtney Lynn Borland, APRN
• Michael Bouchard II, DPM
• Anne Brereton, APRN
• Deborah Jean Brown, NP
• Philip A Brown, DO
• Kathleen A Bryant, NP
• Bte Gastroenterology, LLC

• Family Nurse Practitioner in Berlin, VT
• Providers in Berlin, VT by specialty
• Family Nurse Practitioner in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.