Kimberly A Blaisdell, PT, MED

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040-0002341 Issued in VT

Practice address

111 Colchester Ave
MCHV Campus Shep 2 PT Dept
Burlington, VT 05401-1473

Phone

(802) 847-4731

Fax

(802) 847-3756

NPI assigned

Aug 22, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other names 1

• Mrs. Kimberly Blaisdell Woods Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215043187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 VALLEYVIEW DR",
            "city": "ESSEX JCT",
            "state": "VT",
            "postal_code": "054523825",
            "telephone_number": "802-878-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "address_2": "MCHV CAMPUS SHEP 2 PT DEPT",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-4731",
            "fax_number": "802-847-3756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISDELL",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "PT, MED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040-0002341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WOODS",
            "middle_name": "BLAISDELL",
            "prefix": "MRS.",
            "credential": "PT MED",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mara Black
• Michelle Lee Black, ATC
• Spencer L. Blackman, MD
• Alexander Blair
• Linda S Blair, LICSW
• Kimberly Blake, M.D.
• Colin Henry Blanchard
• Meaghan Blanchard, DPT
• Kelly Curtis Blanchet, MD
• Kristin Blanchette, LCMHC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.