Individual provider Active NPI

Nicholas A Fredette, DNP

  • Primary Care Nurse Practitioner
  • Burlington, VT
National Provider Identifier
1710469481
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
101.0134186 Issued in VT
Practice address
28 S. Williams St.
Burlington, VT 05401
Phone
(802) 558-7595
NPI assigned
Aug 30, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 101.0134186 VT
Gerontology Nurse Practitioner 363LG0600X 101.0134186 VT
Primary Care Nurse Practitioner 363LP2300X 101.0134186 VT Primary

Addresses

Primary practice location

28 S. Williams St.
Burlington, VT 05401

Mailing address

28 S Williams St
Burlington, VT 05401

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
I20190128001559 VT Practitioner - Nurse Practitioner 4183961253 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Vermont College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christopher J Hebert PCGroup PAC ID 1658300793, 2 clinicians

Practice addresses (Care Compare)

550 Hinesburg Rd
Suite 201
South Burlington, VT 05403-6542
Phone (802) 864-0677

Hospital & facility affiliations

  • Univ. of Vermont - Fletcher Allen Health Care Hospital, Burlington, VT, CCN 470003
  • Wake Robin-Linden Nursing Home Nursing home, Shelburne, VT, CCN 475056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101.0134186VTMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher J Hebert PC CurrentSince Dec 5, 2018 Accepting new patients
Green Mountain Internal Medicine PLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

200 Wake Robin Dr
Shelburne, VT 05482
Phone (802) 264-5139

550 Hinesburg Rd
Ste 201
South Burlington, VT 05403
Phone (802) 864-0677

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1710469481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 S WILLIAMS ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "05401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 S. WILLIAMS ST.",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "05401",
            "telephone_number": "802-558-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDETTE",
        "first_name": "NICHOLAS",
        "middle_name": "A",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VT",
            "license": "101.0134186",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VT",
            "license": "101.0134186",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VT",
            "license": "101.0134186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.