Individual provider Active NPI

Bryant D Hazelton, PT

  • Physical Therapist
  • Milton, VT
National Provider Identifier
1396033197
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040.0077317 Issued in VT
Practice address
184 Route 7 S
Milton, VT 05468-3602
Phone
(802) 893-7427
Fax
(802) 893-7429
NPI assigned
Jul 13, 2011
Last updated
Jun 28, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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 040.0077317 VT Primary

Addresses

Primary practice location

184 Route 7 S
Milton, VT 05468-3602

Mailing address

74 Vermont Route 15
Jericho, VT 05465-3011
Phone (802) 899-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110830000031 VT Practitioner - Physical Therapist in Private Practice 4789854829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Transitions Physical Therapy LLCGroup PAC ID 7113188624, 5 clinicians

Practice addresses (Care Compare)

74 VT Route 15
Jericho, VT 05465-3011
Phone (802) 899-5200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040.0077317VTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Transitions Physical Therapy LLC Physical Therapist CurrentSince Jun 17, 2019 Accepting new patients

Locations

74 Vt Route 15
Jericho, VT 05465
Phone (802) 857-5976

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1396033197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 VERMONT ROUTE 15",
            "city": "JERICHO",
            "state": "VT",
            "postal_code": "054653011",
            "telephone_number": "802-899-5200",
            "fax_number": "802-899-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 ROUTE 7 S",
            "city": "MILTON",
            "state": "VT",
            "postal_code": "054683602",
            "telephone_number": "802-893-7427",
            "fax_number": "802-893-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAZELTON",
        "first_name": "BRYANT",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-13",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040.0077317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.