Eric Lyle Gosselin, P.T., ATC, CSCS

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT3292 Issued in ME

Practice address

82 Vesper St
Apt 1
Portland, ME 04101-4493

Phone

(407) 791-3723

NPI assigned

May 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Select Physical Therapy Holdings Inc

  • Physical Therapy Clinic/Center
  • Ashland, VA
  • NPI 1174591218
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1235342643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 BATH RD",
            "address_2": "SUITE 2",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112671",
            "telephone_number": "407-791-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 VESPER ST",
            "address_2": "APT 1",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014493",
            "telephone_number": "407-791-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSSELIN",
        "first_name": "ERIC",
        "middle_name": "LYLE",
        "credential": "P.T., ATC, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "ME",
            "license": "PT3292",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 22300",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "17755",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL 1851",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janene S Gorham, RN, FNP-C
• Alison Carrie Gorman, M.D.
• Rachel Gormley, MD
• Corina Esther Gornes, CRNA
• Katharine Griffin Gorsky, MD
• Patricia M Gosselin, AU.D.
• Emil C Gotschlich, MD
• Elizabeth Hope Gottfried
• Laura Gottfried, LCSW
• Sujana Gottumukkala, MD

• Orthopedic Physical Therapist in Portland, ME
• Providers in Portland, ME by specialty
• Orthopedic Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.