Myra Gene Ann Degre, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040.0134191 Issued in VT

Practice address

85 Beach St
Derby Line, VT 05830-9302

Phone

(802) 673-8315

NPI assigned

Aug 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Freedom Physical Therapy, P.CGroup PAC ID 2062512593, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Freedom Physical Therapy, P.C

  • Physical Therapist
  • Newport, VT
  • NPI 1073717112

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1597536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597536000000",
    "number": "1386255925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 BEACH ST",
            "city": "DERBY LINE",
            "state": "VT",
            "postal_code": "058309302",
            "telephone_number": "802-673-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 BEACH ST",
            "city": "DERBY LINE",
            "state": "VT",
            "postal_code": "058309302",
            "telephone_number": "802-673-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRE",
        "first_name": "MYRA",
        "middle_name": "GENE ANN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-16",
        "last_updated": "2020-08-16",
        "certification_date": "2020-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040.0134191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Michelle Beswick
• Briana Bonnell
• Border Pediatrics
• Browns Drug Store
• Catherine Anne Clark, LCMHC
• Derby Line Ambulance
• Miriam Blodgett Tatum, M.D.
• Vermont Catholic Charities, Inc. (Michaud Memorial Manor)
• Cameron Ward, LMSW

• Physical Therapist in Derby Line, VT
• Providers in Derby Line, VT by specialty
• Physical Therapist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2020; 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.