Individual provider Active NPI

Heidi E Wehr-Kubalova, PT

  • Physical Therapist
  • Stowe, VT
National Provider Identifier
1083752976
Registry record updated Oct 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040-0003611 Issued in VT
Practice address
147 S Main St
#2B
Stowe, VT 05672-5198
Phone
(802) 760-7340
NPI assigned
Feb 2, 2007
Last updated
Oct 17, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 040-0003611 VT Primary

Addresses

Primary practice location

147 S Main St
#2B
Stowe, VT 05672-5198

Mailing address

PO Box 1204
Stowe, VT 05672-1204
Phone (802) 760-7340

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200228000922 VT Practitioner - Physical Therapist in Private Practice 4880021088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Copley Hospital IncGroup PAC ID 9234125766, 61 clinicians

Practice addresses (Care Compare)

528 Washington Hwy
Morrisville, VT 05661-8973
Phone (802) 888-8888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040-0003611VTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Copley Hospital, Inc CurrentSince Mar 1, 2020 Accepting new patients
Copley Hospital, Inc. Current Accepting new patients
Copley Hospital, Inc. Current Accepting new patients
Copley Hospital Inc Current Accepting new patients
Copley Hospital, Inc. CurrentSince Mar 1, 2020 Accepting new patients
Copley Hospital, Inc. Past Accepting new patients
Stable Journeys, LLC Physical Therapist Past Accepting new patients

Locations

528 Washington Hwy
Morrisville, VT 05661
Phone (802) 888-4231

528 Washington Hwy
Ofc
Morrisville, VT 05661

189 Prouty Dr
Newport, VT 05855
Phone (802) 334-3569

Organizations & group practices 7

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287273600000",
    "number": "1083752976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1204",
            "city": "STOWE",
            "state": "VT",
            "postal_code": "056721204",
            "telephone_number": "802-760-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 S MAIN ST",
            "address_2": "#2B",
            "city": "STOWE",
            "state": "VT",
            "postal_code": "056725198",
            "telephone_number": "802-760-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEHR-KUBALOVA",
        "first_name": "HEIDI",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2010-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040-0003611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stowe, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2010; 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.