Active NPI
Jane Susan Kaufman, PT
- Physical Therapist
- So Burlington, VT
National Provider Identifier
1407892433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0400000866
- Practice address
- One Kennedy Drive
Suite L2
So Burlington, VT 05403 - Phone
- (802) 863-6662
- Fax
- (802) 861-2224
- NPI assigned
- Jun 20, 2006
- Last updated
- Feb 22, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 0400000866 | VT | Primary |
Addresses
Primary practice location
One Kennedy Drive
Suite L2
So Burlington, VT 05403
Mailing address
PO Box 4061
Burlington, VT 05406
Phone (802) 863-6662
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007600 | Medicaid | VT | |
| 11351767 | Other | VT | CAQH |
| 5277601 | Other | VT | FAHC |
| 714581 | Other | VT | MVP |
| 4726 | Other | VT | BLUE CROSS BLUE SHIELD |
| 4726 | Other | VT | TVHP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0400000866 | VT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Center of Vermont LLC | Physical Therapist | Past | Accepting new patients |
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.
-
dba The Edge Physical Therapy
- Physical Therapist
- South Burlington, VT
- NPI 1700919818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203638400000",
"number": "1407892433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4061",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "05406",
"telephone_number": "802-863-6662",
"fax_number": "802-861-2224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE KENNEDY DRIVE",
"address_2": "SUITE L2",
"city": "SO BURLINGTON",
"state": "VT",
"postal_code": "05403",
"telephone_number": "802-863-6662",
"fax_number": "802-861-2224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAUFMAN",
"first_name": "JANE",
"middle_name": "SUSAN",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-20",
"last_updated": "2008-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VT",
"license": "0400000866",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007600",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11351767",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FAHC",
"identifier": "5277601",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "714581",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "4726",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TVHP",
"identifier": "4726",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in So Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.