Individual provider Active NPI

Kristen Campbell, SC.D.

  • Audiologist
  • Colchester, VT
National Provider Identifier
1699088724
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
145.0133309 Issued in VT
Practice address
790 College Pkwy
Colchester, VT 05446-3007
Phone
(802) 847-3970
Fax
(802) 847-5880
NPI assigned
Jul 18, 2010
Last updated
Nov 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 41YA0077800 NJ
Audiologist 231H00000X 145.0133309 VT Primary
Hearing Instrument Specialist 237700000X 25MG00119500 NJ

Addresses

Primary practice location

790 College Pkwy
Colchester, VT 05446-3007

Mailing address

5 Watkins Rd
Milton, VT 05468-3836
Phone (732) 598-6554

Other names 1

  • Kristen Olsen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190312001425 VT Practitioner - Qualified Audiologist 9436339660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41YA0077800NJMDAudiologist
25MG00119500NJMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc CurrentSince Feb 1, 2019 Accepting new patients

Locations

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

790 College Pkwy
Colchester, VT 05446
Phone (802) 847-1170

790 College Pkwy
#2
Colchester, VT 05446

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1279411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1699088724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WATKINS RD",
            "city": "MILTON",
            "state": "VT",
            "postal_code": "054683836",
            "telephone_number": "732-598-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 COLLEGE PKWY",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054463007",
            "telephone_number": "802-847-3970",
            "fax_number": "802-847-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KRISTEN",
        "credential": "SC.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-18",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA0077800",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VT",
            "license": "145.0133309",
            "primary": true
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NJ",
            "license": "25MG00119500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "OLSEN",
            "credential": "SC.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colchester, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.