Lisa Kelley, C.N.M.

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

101-0014084 Issued in VT

Practice address

1775 Williston Rd
Suite 220
South Burlington, VT 05403-6491

Phone

(802) 861-0200

Fax

(802) 861-0210

NPI assigned

Dec 29, 2005

Last updated

Aug 13, 2010By the provider in NPPES

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 identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lkelley8258@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vermont Gynecology, PC

  • Gynecology Physician
  • South Burlington, VT
  • NPI 1174830251
  Medicare reassignment NPD
• Mt Mansfield Obstetrics and Gynecology

  • Obstetrics & Gynecology Physician
  • South Burlington, VT
  • NPI 1245563584
  NPD (past)
• Nancy Carlson Fisher MD PC

  • Obstetrics & Gynecology Physician
  • South Burlington, VT
  • NPI 1588803290
  NPD (past)

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1447237516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 BARTLETT BAY RD",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037737",
            "telephone_number": "802-777-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 WILLISTON RD",
            "address_2": "SUITE 220",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036491",
            "telephone_number": "802-861-0200",
            "fax_number": "802-861-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "LISA",
        "credential": "C.N.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "VT",
            "license": "101-0014084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "361683",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009149",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VERMONT MANAGED CARE",
            "identifier": "5207602",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00059280",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abd Al Hadi Kawaiah
• Kci USA, Inc. (Solventum Advanced Wound Care)
• Nicole Kearney, ND
• Clara M Keegan, MD
• Kelley Pharmacy Inc (Custom Prescription Shoppe)
• Ciera Kelly
• Jennifer J Kelly, DO
• Barbara C Kennedy, MD
• Karen D Kennedy, PT
• Kathryn Kennedy, DC

• Advanced Practice Midwife in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Advanced Practice Midwife in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.