NPIMap

Organization Active NPI

Freedom Physical Therapy, P.C

  • Physical Therapist
  • Newport, VT
National Provider Identifier
1073717112
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0400003488 Issued in VT
Legal business name
FREEDOM PHYSICAL THERAPY, P.C
Practice address
419A VT RT 105
Suite B
Newport, VT 05855
Phone
(802) 766-4799
NPI assigned
Jun 13, 2007
Last updated
Dec 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Authorized official

Name
Mrs. Johanne Breton Richardson, MPTNPI 1356345847
Title
Owner Physical Therapist
Phone
(802) 334-2400

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 Therapist 225100000X 0400003488 VT Primary

Addresses

Primary practice location

419A VT RT 105
Suite B
Newport, VT 05855

Mailing address

PO Box 626
Derby, VT 05829-0626
Phone (802) 334-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070712000211 VT Part B Supplier - Clinic/Group Practice 2062512593 Receives reassigned benefits from 6 practitioners
Practice locations: Newport, VT

National Provider Directory

National Provider Directory

Locations

417 Vt Route 105
Newport, VT 05855
Phone (802) 334-2400

419A Vt Route 105
Ste B
Newport, VT 05855
Phone (802) 334-2400

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1073717112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 626",
            "city": "DERBY",
            "state": "VT",
            "postal_code": "058290626",
            "telephone_number": "802-334-2400",
            "fax_number": "802-334-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419A VT RT 105",
            "address_2": "SUITE B",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "05855",
            "telephone_number": "802-766-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM PHYSICAL THERAPY, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "JOHANNE",
        "authorized_official_middle_name": "BRETON",
        "authorized_official_title_or_position": "OWNER  PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "802-334-2400",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "0400003488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.