Individual provider Active NPI

Rebecca Ouellette-Morton

  • Physical Therapist
  • Williston, VT
National Provider Identifier
1336224724
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040-0003698 Issued in VT
Practice address
30 Hawthorne St
Maple Tree Place
Williston, VT 05495-8212
Phone
(802) 876-6000
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 040-0003698 VT Primary

Addresses

Primary practice location

30 Hawthorne St
Maple Tree Place
Williston, VT 05495-8212

Mailing address

276 Butternut LN
Hinesburg, VT 05461-3108
Phone (802) 482-3213

Other identifiers 2

IdentifierTypeStateIssuer
00069556OtherVTBCBS
1012971MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070423000095 VT Practitioner - Physical Therapist in Private Practice 1658476544 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Physical Therapy, PLLCGroup PAC ID 4284606468, 3 clinicians

Practice addresses (Care Compare)

1775 Williston Rd
Suite 104
South Burlington, VT 05403-6491
Phone (802) 863-6662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040-0003698VTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Physical Therapy PLLC Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients
Dee Physical Therapy Services PLC Physical Therapist CurrentSince Sep 4, 2018 Accepting new patients
Transitions Physical Therapy LLC Physical Therapist PastSince Dec 27, 2012 Accepting new patients
The Rehabgym Inc Physical Therapist PastSince Jun 20, 2005 Accepting new patients

Locations

166 Athletic Dr
Shelburne, VT 05482
Phone (802) 985-4440

1775 Williston Rd
Ste 104
South Burlington, VT 05403
Phone (802) 863-6662

23 San Remo Dr
Ste 101
South Burlington, VT 05403
Phone (802) 865-0010

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336224724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "276 BUTTERNUT LN",
            "city": "HINESBURG",
            "state": "VT",
            "postal_code": "054613108",
            "telephone_number": "802-482-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HAWTHORNE ST",
            "address_2": "MAPLE TREE PLACE",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054958212",
            "telephone_number": "802-876-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUELLETTE-MORTON",
        "first_name": "REBECCA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040-0003698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00069556",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012971",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, VT

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.