NPIMap

Individual provider Active NPI

Clodagh Coghlan, N.P.

  • Nurse Practitioner
  • South Burlington, VT
National Provider Identifier
1417908286
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1010018859 Issued in VT
Practice address
368 Dorset St
Suite 1
South Burlington, VT 05403-6236
Phone
(802) 860-1441
NPI assigned
May 15, 2006
Last updated
Aug 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1010018859 VT Primary

Addresses

Primary practice location

368 Dorset St
Suite 1
South Burlington, VT 05403-6236

Mailing address

368 Dorset St
Suite 1
South Burlington, VT 05403-6236
Phone (802) 860-1441

Other practice location 1

184 S Winooski Ave
Burlington, VT 05401-4535
Phone (802) 864-6309

Other practice location 2

789 Pine St
Burlington, VT 05401-4924
Phone (802) 864-0693

Other identifiers 2

IdentifierTypeStateIssuer
ONP1034MedicaidVT
500016102OtherVTRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050624000101 VT Practitioner - Nurse Practitioner 7618912148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

368 Dorset St
Suite 1
South Burlington, VT 05403-6236
Phone (802) 860-1441

617 Riverside Ave
Burlington, VT 05401-1601
Phone (802) 864-6309

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1010018859VTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of Burlington Inc CurrentSince Jul 1, 2016 Accepting new patients
Community Health Centers of Burlington Inc CurrentSince Jul 1, 2016 Accepting new patients
Community Health Centers of Burlington Inc Past Accepting new patients

Locations

184 S Winooski Ave
Burlington, VT 05401
Phone (802) 860-4310

617 Riverside Ave
Burlington, VT 05401
Phone (802) 264-8158

789 Pine St
Burlington, VT 05401
Phone (802) 264-1052

368 Dorset St
Ste 1
South Burlington, VT 05403
Phone (802) 860-1441

Interoperability endpoints

  • Direct secure messaging: clodagh.coghlan.p1@direct.chcb.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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 12

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": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1417908286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 DORSET ST",
            "address_2": "SUITE 1",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036236",
            "telephone_number": "802-860-1441",
            "fax_number": "802-860-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 DORSET ST",
            "address_2": "SUITE 1",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036236",
            "telephone_number": "802-860-1441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "184 S Winooski Ave",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054014535",
            "country_code": "US",
            "telephone_number": "802-864-6309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "789 Pine St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054014924",
            "country_code": "US",
            "telephone_number": "802-864-0693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COGHLAN",
        "first_name": "CLODAGH",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VT",
            "license": "1010018859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ONP1034",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "500016102",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.