Individual provider Active NPI

Kristen Smith Bird, FNP-BC, IBCLC

  • Family Nurse Practitioner
  • Burlington, VT
National Provider Identifier
1851659270
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
101.0085890 Issued in VT
Practice address
1127 North Ave
Suite 41
Burlington, VT 05408-2757
Phone
(802) 846-8100
NPI assigned
Apr 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 10912104 VT
Family Nurse Practitioner 363LF0000X 101.0085890 VT Primary

Addresses

Primary practice location

1127 North Ave
Suite 41
Burlington, VT 05408-2757

Mailing address

600 Blair Park Rd Ste 285
Williston, VT 05495-7586
Phone (802) 288-1140

Other identifiers 1

IdentifierTypeStateIssuer
1020570MedicaidVT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kbird@pchpmd.medentdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10912104VTMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care Health Partners - New York LLP CurrentSince Jul 2, 2023 Accepting new patients
Primary Care Health Partners Past Accepting new patients

Locations

600 Blair Park Rd
Ste 285
Williston, VT 05495
Phone (802) 288-1140

66 Knight Ln
Ste 10
Williston, VT 05495
Phone (802) 872-4327

Interoperability endpoints

  • Direct secure messaging: kbird@pchpmd.medentdirect.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1851659270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BLAIR PARK RD STE 285",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957586",
            "telephone_number": "802-288-1140",
            "fax_number": "802-288-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1127 NORTH AVE",
            "address_2": "SUITE 41",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054082757",
            "telephone_number": "802-846-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRD",
        "first_name": "KRISTEN",
        "middle_name": "SMITH",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-24",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "VT",
            "license": "10912104",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101.0085890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020570",
            "state": "VT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbird@pchpmd.medentdirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1127 North Ave",
            "address_2": "Suite 41",
            "city": "Burlington",
            "state": "VT",
            "country_code": "US",
            "postal_code": "054082757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.