Individual provider Active NPI

Patrick Giblin, OTR/L

  • Occupational Therapist
  • Shelburne, VT
National Provider Identifier
1073054342
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0720134030 Issued in VT
Practice address
145 Pine Haven Shores Rd
Shelburne, VT 05482-7703
Phone
(585) 704-4662
NPI assigned
Mar 20, 2017
Last updated
Dec 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0720134030 VT Primary

Addresses

Primary practice location

145 Pine Haven Shores Rd
Shelburne, VT 05482-7703

Mailing address

349 Flynn Ave
Burlington, VT 05401-5014
Phone (585) 704-4662

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

State licenses

LicenseStateTypeSpecialty
0720134030VTMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1073054342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 FLYNN AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015014",
            "telephone_number": "585-704-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 PINE HAVEN SHORES RD",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054827703",
            "telephone_number": "585-704-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBLIN",
        "first_name": "PATRICK",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VT",
            "license": "0720134030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelburne, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.