NPIMap

Organization Active NPI

County Physical Therapy, LLC

  • Physical Therapist
  • Caribou, ME
National Provider Identifier
1386686616
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
COUNTY PHYSICAL THERAPY, LLC
Practice address
118 Bennett Dr
Suite 140
Caribou, ME 04736-2052
Phone
(207) 498-6334
Fax
(207) 493-3247
NPI assigned
Jun 12, 2006
Last updated
Jul 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Authorized official

Name
Mr. Richard J Ezzy
Title
Vice President
Phone
(207) 498-6334

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

118 Bennett Dr
Suite 140
Caribou, ME 04736-2052

Mailing address

118 Bennett Dr
Suite 140
Caribou, ME 04736-2052
Phone (207) 498-6334

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050415000373 ME Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3779520242 Receives reassigned benefits from 19 practitioners
Practice locations: Fort Kent, ME; Presque Isle, ME; Houlton, ME; Caribou, ME; Bangor, ME

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

82 Sylvan Rd
Bangor, ME 04401
Phone (207) 401-4324

118 Bennett Dr
Ste 140
Caribou, ME 04736
Phone (207) 498-6334

43 Hatch Dr
Ste 140
Caribou, ME 04736
Phone (207) 498-6334

98 Bangor St
Ste A
Houlton, ME 04730
Phone (207) 521-0200

460 Main St
Ste 10
Madawaska, ME 04756
Phone (207) 728-7778

5 North St
Presque Isle, ME 04769
Phone (207) 769-2160

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752537600000",
    "number": "1386686616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 BENNETT DR",
            "address_2": "SUITE 140",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047362052",
            "telephone_number": "207-498-6334",
            "fax_number": "207-493-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 BENNETT DR",
            "address_2": "SUITE 140",
            "city": "CARIBOU",
            "state": "ME",
            "postal_code": "047362052",
            "telephone_number": "207-498-6334",
            "fax_number": "207-493-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "EZZY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "207-498-6334",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caribou, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; 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.

Verify at the official NPI Registry.