Individual provider Active NPI

Matthew Betz, PT, DPT

  • Physical Therapist
  • South Burlington, VT
National Provider Identifier
1104363894
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040.0126919 Issued in VT
Practice address
340 Dorset St
South Burlington, VT 05403-6306
Phone
(717) 991-2374
NPI assigned
Jan 19, 2017
Last updated
Jan 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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 040.0126919 VT Primary

Addresses

Primary practice location

340 Dorset St
South Burlington, VT 05403-6306

Mailing address

388 Autumn Pond Way
Unit 2
Essex Junction, VT 05452-4063
Phone (717) 991-2374

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
040.0126919VTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1104363894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 AUTUMN POND WAY",
            "address_2": "UNIT 2",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054524063",
            "telephone_number": "717-991-2374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 DORSET ST",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036306",
            "telephone_number": "717-991-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETZ",
        "first_name": "MATTHEW",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040.0126919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.