Active NPI
Kirsten Bergen Grace, APRN
- Family Nurse Practitioner
- St Johnsbury, VT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 101-0118108
- Practice address
- 1315 Hospital Dr
St Johnsbury, VT 05819-9210 - Phone
- (802) 748-8141
- Fax
- (802) 748-4098
- NPI assigned
- Jul 19, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 88494 | CT | |
| Family Nurse Practitioner | 363LF0000X | 076241-23 | NH | |
| Family Nurse Practitioner | 363LF0000X | 004399 | CT | |
| Family Nurse Practitioner | 363LF0000X | 101-0118108 | VT | Primary |
Addresses
Primary practice location
1315 Hospital Dr
St Johnsbury, VT 05819-9210
Mailing address
PO Box 905
St Johnsbury, VT 05819-0905
Phone (802) 748-8141
Other practice location 1
551 Meadow St
Littleton, NH 03561-3615
Phone (603) 761-3660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004399 | Other | CT | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 88494 | CT | MD | Registered Nurse |
| 076241-23 | NH | MD | Family Nurse Practitioner |
| 101-0118108 | VT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Convenientmd - FFS UC LLC | Current | Accepting new patients | |
| Convenientmd - FFS UC LLC | Current | Accepting new patients |
Locations
3 Nashua Rd
Bedford, NH 03110
Phone (603) 472-6700
551 Meadow St
Littleton, NH 03561
Phone (603) 761-3660
360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Urgent Care Clinic/Center
- Nashua, NH
- NPI 1851082291
-
- Urgent Care Clinic/Center
- Sturbridge, MA
- NPI 1386526192
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704153600000",
"number": "1841503935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 905",
"city": "ST JOHNSBURY",
"state": "VT",
"postal_code": "058190905",
"telephone_number": "802-748-8141",
"fax_number": "802-748-4098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 HOSPITAL DR",
"city": "ST JOHNSBURY",
"state": "VT",
"postal_code": "058199210",
"telephone_number": "802-748-8141",
"fax_number": "802-748-4098"
}
],
"practiceLocations": [
{
"address_1": "551 Meadow St",
"address_purpose": "LOCATION",
"city": "Littleton",
"state": "NH",
"postal_code": "035613615",
"country_code": "US",
"telephone_number": "603-761-3660",
"fax_number": "603-761-7791",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRACE",
"first_name": "KIRSTEN",
"middle_name": "BERGEN",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-19",
"last_updated": "2024-01-02",
"certification_date": "2024-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CT",
"license": "88494",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NH",
"license": "076241-23",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "004399",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "VT",
"license": "101-0118108",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "004399",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St Johnsbury, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.