NPIMap

Individual provider Active NPI

Joshua Earl Wellenstein, PT, DPT

  • Orthopedic Physical Therapist
  • South Burlington, VT
National Provider Identifier
1194792440
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
0400061031 Issued in VT
Practice address
21 Gregory Dr
C/O Poulin Performance, Inc.
South Burlington, VT 05403-6080
Phone
(802) 658-0949
Fax
(802) 658-1436
NPI assigned
Mar 7, 2006
Last updated
Mar 19, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0226101 NY
Orthopedic Physical Therapist 2251X0800X 0400061031 VT Primary

Addresses

Primary practice location

21 Gregory Dr
C/O Poulin Performance, Inc.
South Burlington, VT 05403-6080

Mailing address

21 Gregory Dr
C/O Poulin Performance, Inc.
South Burlington, VT 05403-6080
Phone (802) 658-0949

Other identifiers 1

IdentifierTypeStateIssuer
10064961OtherCDPHP

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
0226101NYMDPhysical Therapist
0400061031VTMDOrthopedic Physical Therapist
022610NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher Page Physical Therapy P.C. Physical Therapist Past Accepting new patients
Poulin Performance, Inc. Physical Therapist PastSince Nov 20, 1996 Accepting new patients
Fitness Forum Physical Therapy, PC Physical Therapist Past Accepting new patients
Sports Physical Therapy of New York, P.C. Physical Therapist PastSince Apr 1, 2003 Accepting new patients

Organizations & group practices 4

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1194792440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GREGORY DR",
            "address_2": "C/O POULIN PERFORMANCE, INC.",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036080",
            "telephone_number": "802-658-0949",
            "fax_number": "802-658-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GREGORY DR",
            "address_2": "C/O POULIN PERFORMANCE, INC.",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036080",
            "telephone_number": "802-658-0949",
            "fax_number": "802-658-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLENSTEIN",
        "first_name": "JOSHUA",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0226101",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VT",
            "license": "0400061031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP",
            "identifier": "10064961",
            "state": null
        }
    ],
    "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 Mar 19, 2010; 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.