Active NPI
Johan Jules Uylenbroeck, PT, MBA, CLT, LSVT
- Physical Therapist
- Nashua, NH
National Provider Identifier
1295976132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1918
- Practice address
- 319 E Dunstable Rd
Nashua, NH 03062-4207 - Phone
- (603) 273-6459
- NPI assigned
- Mar 23, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 040.0003053 | VT | |
| Physical Therapist | 225100000X | 1918 | NH | Primary |
Addresses
Primary practice location
319 E Dunstable Rd
Nashua, NH 03062-4207
Mailing address
26 Massachusetts Ave
Meredith, NH 03253-5710
Phone (603) 366-8508
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060127000654 | VT | Practitioner - Physical Therapist in Private Practice | 4183638216 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040.0003053 | VT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704240000000",
"number": "1295976132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 MASSACHUSETTS AVE",
"city": "MEREDITH",
"state": "NH",
"postal_code": "032535710",
"telephone_number": "603-366-8508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 E DUNSTABLE RD",
"city": "NASHUA",
"state": "NH",
"postal_code": "030624207",
"telephone_number": "603-273-6459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UYLENBROECK",
"first_name": "JOHAN",
"middle_name": "JULES",
"name_prefix": "Mr.",
"credential": "PT, MBA, CLT, LSVT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-23",
"last_updated": "2024-01-03",
"certification_date": "2024-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VT",
"license": "040.0003053",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NH",
"license": "1918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nashua, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.