Individual provider Active NPI

Beth Schiller, AGNP

  • Adult Health Nurse Practitioner
  • S Burlington, VT
National Provider Identifier
1396141966
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
101.0109026 Issued in VT
Practice address
150 Kennedy Dr
S Burlington, VT 05403-6749
Phone
(802) 448-9370
Fax
(802) 448-1414
NPI assigned
Nov 10, 2014
Last updated
Nov 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 101.0109026 VT Primary

Addresses

Primary practice location

150 Kennedy Dr
S Burlington, VT 05403-6749

Mailing address

607 Middle Rd
Essex, NY 12936-2533

Other identifiers 2

IdentifierTypeStateIssuer
101.0109026OtherVTAGNP LICENSE
665408OtherNYRN LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150427001444 VT Practitioner - Nurse Practitioner 6709040066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Champlain Medical Associates PLLCGroup PAC ID 4981868247, 5 clinicians

Practice addresses (Care Compare)

150 Kennedy Dr
South Burlington, VT 05403-6749

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Champlain Medical Associates PLLC CurrentSince Feb 1, 2013 Accepting new patients
Hoeppner Physical Therapy Limited Partnership CurrentSince Apr 20, 2015 Accepting new patients

Locations

150 Kennedy Dr
South Burlington, VT 05403
Phone (802) 448-9370

Organizations & group practices 2

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1396141966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 MIDDLE RD",
            "city": "ESSEX",
            "state": "NY",
            "postal_code": "129362533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 KENNEDY DR",
            "city": "S BURLINGTON",
            "state": "VT",
            "postal_code": "054036749",
            "telephone_number": "802-448-9370",
            "fax_number": "802-448-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILLER",
        "first_name": "BETH",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-10",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VT",
            "license": "101.0109026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGNP LICENSE",
            "identifier": "101.0109026",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "665408",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in S Burlington, VT

Sources for this page

Verify at the official NPI Registry.