NPIMap

Organization Active NPI

Timberlane Physical Therapy Inc

  • Physical Therapist
  • Winooski, VT
National Provider Identifier
1063583441
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TIMBERLANE PHYSICAL THERAPY INC
Practice address
321 Main Street
Suite D
Winooski, VT 05404
Phone
(802) 864-3785
Fax
(802) 864-0274
NPI assigned
Nov 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Authorized official

Name
Lesli R Bell, PTNPI 1437220811
Title
Owner President
Phone
(802) 864-3785

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

321 Main Street
Suite D
Winooski, VT 05404

Mailing address

321 Main Street
Suite D
Winooski, VT 05404
Phone (802) 864-3785

Other identifiers 1

IdentifierTypeStateIssuer
00018200OtherBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060425000064 VT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1951311778 Receives reassigned benefits from 3 practitioners
Practice locations: Winooski, VT

National Provider Directory

National Provider Directory

Locations

40 Timber Ln
#B
South Burlington, VT 05403
Phone (802) 862-4265

321 Main St
Ste D
Winooski, VT 05404
Phone (802) 864-3785

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365638400000",
    "number": "1063583441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MAIN STREET",
            "address_2": "SUITE D",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "05404",
            "telephone_number": "802-864-3785",
            "fax_number": "802-864-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MAIN STREET",
            "address_2": "SUITE D",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "05404",
            "telephone_number": "802-864-3785",
            "fax_number": "802-864-0274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMBERLANE PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2013-04-11",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "LESLI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "802-864-3785",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00018200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winooski, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.