Randy G Berube, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1772 Issued in NH

Practice address

700 Lake Ave
Manchester, NH 03103-2734

Phone

(603) 625-1864

Fax

(603) 668-7181

NPI assigned

Jul 7, 2005

Last updated

Jul 11, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Merrimack Valley Physical Therapy

  dba MVPT Physical Therapy

  • Physical Therapist
  • Bedford, NH
  • NPI 1194771139
  NPD (past)

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1306843024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 LAKE AVE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031032734",
            "telephone_number": "603-625-1864",
            "fax_number": "603-668-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LAKE AVE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031032734",
            "telephone_number": "603-625-1864",
            "fax_number": "603-668-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERUBE",
        "first_name": "RANDY",
        "middle_name": "G",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NH",
            "license": "1772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30392139",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen E Berthiaume, RPH
• Erin Bertoli, BCBA, LBS
• Melissa Renee Bertoulin, MSW LICSW
• Carmen Bertran, LCMHC
• Kassondra Bertulis, PSYD
• Richard G Berube, D.M.D
• Stephen Berube, D.M.D
• Beryl Inpatient Services
• Yulia Bespalova
• Best Ride Transit LLC

• Physical Therapist in Manchester, NH
• Providers in Manchester, NH by specialty
• Physical Therapist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.