Kathleen A Bryant, NP
Individual provider Active NPI Family Nurse Practitioner · Berlin, VT
NPI 1801869748 · NPPES record last updated Jul 28, 2014
Key facts
- NPI
- 1801869748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 101.0022960 (VT)
- Practice address
- 246 Granger Rd
Suite 1
Berlin, VT 05602-9516 - Phone
- (802) 371-5950
- Fax
- (802) 371-5951
- NPI assigned
- Feb 10, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081002000583 | VT | Practitioner - Nurse Practitioner | 5890728901 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101.0022960 | VT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gifford Health Care, Inc | Current |
Accepting new patients | |
| Gifford Health Care, Inc | Current |
Accepting new patients | |
| Umass Memorial Medical Group Inc | Nurse Practitioner | Past | Accepting new patients |
| Gifford Health Care, Inc | Past | Accepting new patients |
Locations
1823 Vt Rte 107
Bethel, VT 05032
Phone (802) 234-2114
44 S Main St
Randolph, VT 05060
Phone (802) 728-4441
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 216464 | MA | |
| Family Nurse Practitioner | 363LF0000X | 101.0022960 | VT | Yes |
Addresses
Primary practice location
246 Granger Rd
Suite 1
Berlin, VT 05602-9516
Mailing address
PO Box 547
Att: CVMC Finance Dept
Barre, VT 05641-0547
Phone (802) 371-5950
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1015078 | Medicaid | VT | |
| 0394190 | Medicaid | MA |
Other providers in Berlin, VT
- Michael Bouchard II
- Keith J Breasure
- Anne Brereton
- Deborah Jean Brown
- Philip A Brown
- Bte Gastroenterology, LLC
- Krista Buckley
- Linda A Burger
- William Bond Burton
- Ann E. Burzynski
All providers in Berlin, VT · Family Nurse Practitioner in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.