Maryclaire McGovern, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040.0133991 Issued in VT

Practice address

62 Merchants Row Ste 202
Williston, VT 05495-4488

Phone

(802) 857-5407

NPI assigned

Jun 7, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Lifestyle Athlete PLCGroup PAC ID 6406272657, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Lifestyle Athlete PLC

  • Physical Therapist
  • Williston, VT
  • NPI 1437778008
  Medicare reassignment Care Compare group NPD
• Reach Hand Therapy PLLC

  • Hand Occupational Therapist
  • Williston, VT
  • NPI 1720768187

  Physical Therapist

  NPD
• Keep Moving Vermont Inc

  • Physical Therapy Clinic/Center
  • Williston, VT
  • NPI 1558191411
  NPD (past)

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1114410909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 MERCHANTS ROW STE 202",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054954488",
            "telephone_number": "802-857-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 MERCHANTS ROW STE 202",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054954488",
            "telephone_number": "802-857-5407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Timber Ln",
            "address_purpose": "LOCATION",
            "city": "South Burlington",
            "state": "VT",
            "postal_code": "054037205",
            "country_code": "US",
            "telephone_number": "802-847-0838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "MARYCLAIRE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040.0133991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah E Mazur, DPT
• Andrew McCanse, D.C.
• Heidi S McClellan, ATC
• McKenzie B McClellan, BCBA
• Tawnya McDonald, LICSW
• Patrick Dennis McGrath, DPT
• Kyle McGregor
• Megan Speck Ms
• Brian Mehaffey, D.C.
• Wendy Mehaffey, D.C.

• Physical Therapist in Williston, VT
• Providers in Williston, VT by specialty
• Physical Therapist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.