NPIMap

Individual provider Active NPI

Clara M Keegan, MD

  • Family Medicine Physician
  • South Burlington, VT
National Provider Identifier
1770542631
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042-0012154 Issued in VT
Practice address
3 Timber LN
South Burlington, VT 05403-7205
Phone
(802) 847-8500
Fax
(802) 847-6140
NPI assigned
Mar 20, 2006
Last updated
Aug 23, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 219879 MA
Family Medicine Physician 207Q00000X 042-0012154 VT Primary

Addresses

Primary practice location

3 Timber LN
South Burlington, VT 05403-7205

Mailing address

3 Timber LN
South Burlington, VT 05403-7205
Phone (802) 847-8500

Other identifiers 1

IdentifierTypeStateIssuer
967199MedicaidMA

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
I20110602000489 VT Practitioner - Family Practice 2466439443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Columbia University College of Physicians and Surgeons, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 S Prospect St
Burlington, VT 05401-3456
Phone (802) 847-0000

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

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
219879MAMDClinical Social Worker
042-0012154VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Family Medicine CurrentSince May 1, 2011 Accepting new patients
Beth Israel Lahey Health Primary Care Inc Past Accepting new patients
University of Vermont Medical Center Inc Past Accepting new patients
Dracut Family Healthcare Family Medicine PastSince Oct 13, 1999 Accepting new patients

Locations

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

3 Timber Ln
South Burlington, VT 05403
Phone (802) 847-3339

Interoperability endpoints

  • Direct secure messaging: ckeegan71057@direct.uvmhealth.org
  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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 4

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1770542631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 TIMBER LN",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037205",
            "telephone_number": "802-847-8500",
            "fax_number": "802-847-6140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 TIMBER LN",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037205",
            "telephone_number": "802-847-8500",
            "fax_number": "802-847-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEGAN",
        "first_name": "CLARA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "219879",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042-0012154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "967199",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.