Individual provider Active NPI

Hannah Van Vleet, DPT

  • Physical Therapist
  • Groton, CT
National Provider Identifier
1336824010
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14028 Issued in CT
Practice address
29 Sandpiper LN
Groton, CT 06340-2616
Phone
(919) 698-2722
NPI assigned
Jun 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13797 TN
Physical Therapist 225100000X P20516 NC
Physical Therapist 225100000X 14028 CT Primary

Addresses

Primary practice location

29 Sandpiper LN
Groton, CT 06340-2616

Mailing address

29 Sandpiper LN
Groton, CT 06340-2616
Phone (919) 698-2722

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231120001151 WA Practitioner - Physical Therapist in Private Practice 7416305180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19505 7TH Ave NE
Poulsbo, WA 98370-7700
Phone (360) 779-3777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14028CTMDPhysical Therapist
P20516NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Oct 17, 2023 Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Oct 17, 2023 Accepting new patients

Locations

19505 7th Ave NE
Poulsbo, WA 98370
Phone (360) 598-3764

2400 NW Myhre Rd
Ste 101
Silverdale, WA 98383
Phone (360) 598-3764

2400 NW Myhre Rd
Ste 102
Silverdale, WA 98383
Phone (360) 598-3764

Organizations & group practices 2

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1336824010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 SANDPIPER LN",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063402616",
            "telephone_number": "919-698-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 SANDPIPER LN",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063402616",
            "telephone_number": "919-698-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN VLEET",
        "first_name": "HANNAH",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "13797",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P20516",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.