NPIMap

Individual provider Active NPI

Kristen E Vickers, PA-C

  • Physician Assistant
  • Saint Albans, VT
National Provider Identifier
1801224753
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
055.0031185 Issued in VT
Practice address
3 Crest Rd
Saint Albans, VT 05478-9753
Phone
(802) 524-4554
Fax
(802) 527-6792
NPI assigned
Oct 30, 2013
Last updated
Nov 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 055.0031185 VT Primary

Addresses

Primary practice location

3 Crest Rd
Saint Albans, VT 05478-9753

Mailing address

44 Main St Ste 200
Richford, VT 05476-1141
Phone (802) 255-5580

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
I20131217000926 VT Practitioner - Physician Assistant 2466689559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
The Richford Health Center, Inc.Group PAC ID 7012825631, 30 clinicians

Practice addresses (Care Compare)

1199 Main St
Fairfax, VT 05454-9530
Phone (802) 849-2844

3 Crest Rd
Saint Albans, VT 05478-9753
Phone (802) 524-4554

64 Industrial Park Rd
Alburg, VT 05440-4170
Phone (802) 796-4414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
055.0031185VTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Richford Health Center Inc CurrentSince Jul 1, 2019 Accepting new patients
The Richford Health Center Inc CurrentSince Jul 1, 2019 Accepting new patients
The Richford Health Center Inc PastSince Sep 5, 2023 Accepting new patients
Fiddlehead Ledge LLC PastSince Aug 8, 2021 Accepting new patients

Locations

1199 Main St
Fairfax, VT 05454
Phone (802) 849-2023

4178 Highbridge Rd
Fairfax, VT 05454
Phone (802) 524-9595

44 Main St
Ste 200
Richford, VT 05476
Phone (802) 255-5500

12 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

26 Canada St
Swanton, VT 05488
Phone (802) 868-2175

Interoperability endpoints

  • Direct secure messaging: kvickers@notch.medentdirect.com

Organizations & group practices 5

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 9

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": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1801224753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 MAIN ST STE 200",
            "city": "RICHFORD",
            "state": "VT",
            "postal_code": "054761141",
            "telephone_number": "802-255-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CREST RD",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054789753",
            "telephone_number": "802-524-4554",
            "fax_number": "802-527-6792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "KRISTEN",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, VT

Sources for this page

Verify at the official NPI Registry.