Individual provider Active NPI

Colleen Mitchell, FNP

  • Family Nurse Practitioner
  • Bomoseen, VT
National Provider Identifier
1821255860
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
101-0041315 Issued in VT
Practice address
275 Route 30 N
Bomoseen, VT 05732-9647
Phone
(802) 468-5641
Fax
(802) 468-2923
NPI assigned
May 19, 2008
Last updated
Aug 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 101-0041315 VT Primary

Addresses

Primary practice location

275 Route 30 N
Bomoseen, VT 05732-9647

Mailing address

275 Route 30 N
Bomoseen, VT 05732-9647
Phone (802) 468-5641

Other identifiers 1

IdentifierTypeStateIssuer
1015194MedicaidVT

Other names 1

  • Colleen Carver Former name

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
I20081014000039 VT Practitioner - Nurse Practitioner 0547337040 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers of the Rutland Region IncGroup PAC ID 2961467386, shared by 9 NPIs, 103 clinicians

Practice addresses (Care Compare)

1 General Wing Rd
Rutland, VT 05701-4681
Phone (802) 773-9131

215 Stratton Rd
Rutland, VT 05701-4621
Phone (802) 773-3386

275 Route 30 N
Bomoseen, VT 05732-9647
Phone (802) 468-5641

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
101-0041315VTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Oct 14, 2014 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Oct 14, 2014 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince May 12, 2008 Accepting new patients
Community Health Centers of the Rutland Region Inc Current Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Oct 14, 2014 Accepting new patients

Locations

275 VT 30 N
Bomoseen, VT 05732
Phone (802) 468-5641

420 Grove St
Brandon, VT 05733
Phone (802) 247-6305

1 General Wing Rd
Rutland, VT 05701
Phone (802) 773-9131

215 Stratton Rd
Rutland, VT 05701
Phone (802) 773-3386

71 Allen St
Ste 402
Rutland, VT 05701
Phone (800) 468-9118

2987 Vt Route 22A
Shoreham, VT 05770
Phone (802) 897-7000

Interoperability endpoints

  • Direct secure messaging: cmitchell@chcrr.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 1

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": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438732800000",
    "number": "1821255860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 ROUTE 30 N",
            "city": "BOMOSEEN",
            "state": "VT",
            "postal_code": "057329647",
            "telephone_number": "802-468-5641",
            "fax_number": "802-468-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 ROUTE 30 N",
            "city": "BOMOSEEN",
            "state": "VT",
            "postal_code": "057329647",
            "telephone_number": "802-468-5641",
            "fax_number": "802-468-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-19",
        "last_updated": "2015-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101-0041315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015194",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "CARVER",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bomoseen, VT

Sources for this page

Verify at the official NPI Registry.