Individual provider Active NPI

Carolyn R Weber, PT

  • Physical Therapist
  • South Birlington, VT
National Provider Identifier
1407811367
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0400003280 Issued in VT
Practice address
150 Kennedy Dr
South Birlington, VT 05403
Phone
(802) 862-4670
Fax
(802) 862-4431
NPI assigned
Apr 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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 0400003280 VT Primary

Addresses

Primary practice location

150 Kennedy Dr
South Birlington, VT 05403

Mailing address

375 Waller Rd
Georgia, VT 05468
Phone (802) 527-2443

Other identifiers 2

IdentifierTypeStateIssuer
5666869001OtherVTCIGNA
OVN2191MedicaidVT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060509000767 VT Practitioner - Physical Therapist in Private Practice 9931110632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leclair Therapy IncGroup PAC ID 4688631211, 17 clinicians

Practice addresses (Care Compare)

1 Market PL
Essex JCT, VT 05452-2942
Phone (802) 878-9572

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0400003280VTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Leclair Therapy, Inc. Physical Therapist CurrentSince Aug 16, 2017 Accepting new patients
Champlain Medical Associates PLLC PastSince Aug 1, 2012 Accepting new patients
Mansfield Physical Therapy Limited Partnership Physical Therapist PastSince Dec 29, 2008 Accepting new patients
Hoeppner Physical Therapy Limited Partnership Physical Therapist PastSince Apr 20, 2015 Accepting new patients
Paquette Therapy Corporation Physical Therapist PastSince Aug 16, 2017 Accepting new patients

Locations

1 Towne Market Pl
Essex Junction, VT 05452
Phone (802) 655-1737

1 Towne Market Pl
Unit 33
Essex Junction, VT 05452
Phone (802) 878-9572

21 Carmichael St
Essex Junction, VT 05452
Phone (802) 878-9572

Organizations & group practices 5

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407811367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 WALLER RD",
            "city": "GEORGIA",
            "state": "VT",
            "postal_code": "05468",
            "telephone_number": "802-527-2443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 KENNEDY DR",
            "city": "SOUTH BIRLINGTON",
            "state": "VT",
            "postal_code": "05403",
            "telephone_number": "802-862-4670",
            "fax_number": "802-862-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "CAROLYN",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "0400003280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5666869001",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN2191",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Birlington, 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.