Individual provider Active NPI

Bridget Shea, RD

  • Registered Dietitian
  • Underhill, VT
National Provider Identifier
1902444862
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1075543 Issued in VT
Practice address
23 Wheeler Rd
Underhill, VT 05489-9303
Phone
(802) 598-5388
NPI assigned
Dec 11, 2019
Last updated
Dec 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1075543 VT Primary

Addresses

Primary practice location

23 Wheeler Rd
Underhill, VT 05489-9303

Mailing address

23 Wheeler Rd
Underhill, VT 05489-9303
Phone (802) 598-5388

Other practice location 1

595 Dorset St
South Burlington, VT 05403-6240
Phone (802) 598-5388

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://www.practicefusion.com/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201218000403 VT Practitioner - Registered Dietitian Or Nutrition Professional 9638581556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1075543VTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
University of Vermont Medical Center Inc Single Specialty CurrentSince Nov 10, 2020 Accepting new patients

Locations

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1902444862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 WHEELER RD",
            "city": "UNDERHILL",
            "state": "VT",
            "postal_code": "054899303",
            "telephone_number": "802-598-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 WHEELER RD",
            "city": "UNDERHILL",
            "state": "VT",
            "postal_code": "054899303",
            "telephone_number": "802-598-5388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "595 Dorset St",
            "address_purpose": "LOCATION",
            "city": "South Burlington",
            "state": "VT",
            "postal_code": "054036240",
            "country_code": "US",
            "telephone_number": "802-598-5388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEA",
        "first_name": "BRIDGET",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VT",
            "license": "1075543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.practicefusion.com/",
            "affiliation": "N",
            "endpointDescription": "Cloud-based EHR",
            "address_1": "23 Wheeler Rd",
            "city": "Underhill",
            "state": "VT",
            "country_code": "US",
            "postal_code": "054899303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Underhill, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.