Active NPI
Alexis Hannigan, PT
- Physical Therapist
- South Burlington, VT
National Provider Identifier
1164580361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 040-0003700
- Practice address
- 192 Tilley Dr
Osc - Rehab Therapies
South Burlington, VT 05403-4440 - Phone
- (802) 847-7003
- Fax
- (802) 847-6987
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 040-0003700 | VT | Primary |
Addresses
Primary practice location
192 Tilley Dr
Osc - Rehab Therapies
South Burlington, VT 05403-4440
Mailing address
192 Tilley Dr
Osc - Rehab Therapies
South Burlington, VT 05403-4440
Phone (802) 847-7003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013020 | Medicaid | VT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 040-0003700 | VT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323648000000",
"number": "1164580361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "192 TILLEY DR",
"address_2": "OSC - REHAB THERAPIES",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054034440",
"telephone_number": "802-847-7003",
"fax_number": "802-847-6987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "192 TILLEY DR",
"address_2": "OSC - REHAB THERAPIES",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054034440",
"telephone_number": "802-847-7003",
"fax_number": "802-847-6987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNIGAN",
"first_name": "ALEXIS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2011-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VT",
"license": "040-0003700",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013020",
"state": "VT"
}
],
"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 Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.