Active NPI
Jeffry E Michaelson, PT
- Physical Therapist
- Morrisville, VT
National Provider Identifier
1164998316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 040.0090189
- Practice address
- 577 Washington Hwy
Morrisville, VT 05661-8972 - Phone
- (802) 888-8700
- NPI assigned
- Oct 15, 2018
- Last updated
- Oct 15, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 040.0090189 | VT | Primary |
Addresses
Primary practice location
577 Washington Hwy
Morrisville, VT 05661-8972
Mailing address
288 N Pinnacle Ridge Rd
Waterbury, VT 05676-1120
Phone (802) 882-8480
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 |
|---|---|---|---|
| 040.0090189 | VT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539561600000",
"number": "1164998316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "288 N PINNACLE RIDGE RD",
"city": "WATERBURY",
"state": "VT",
"postal_code": "056761120",
"telephone_number": "802-882-8480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "577 WASHINGTON HWY",
"city": "MORRISVILLE",
"state": "VT",
"postal_code": "056618972",
"telephone_number": "802-888-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAELSON",
"first_name": "JEFFRY",
"middle_name": "E",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-15",
"last_updated": "2018-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VT",
"license": "040.0090189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morrisville, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.