Individual provider Active NPI

Jane Susan Kaufman, PT

  • Physical Therapist
  • So Burlington, VT
National Provider Identifier
1407892433
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0400000866 Issued in VT
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, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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 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

IdentifierTypeStateIssuer
1007600MedicaidVT
11351767OtherVTCAQH
5277601OtherVTFAHC
714581OtherVTMVP
4726OtherVTBLUE CROSS BLUE SHIELD
4726OtherVTTVHP

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

LicenseStateTypeSpecialty
0400000866VTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Center of Vermont LLC Physical Therapist PastSince Nov 20, 2017 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.

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.

Verify at the official NPI Registry.