Caitlin Carlson Cunningham, DPT

Individual provider Active NPI Physical Therapist · Williston, VT

NPI 1417475666 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1417475666
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
0400130263 (VT)
Practice address
373 Blair Park Rd Unit 204
Williston, VT 05495-8056
Phone
(802) 662-4672
Fax
(802) 662-5964
NPI assigned
Sep 7, 2017
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0400130263VTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Rehabgym Inc. Physical Therapist Past
since Jul 24, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0400130263 VT Yes

Addresses

Primary practice location

373 Blair Park Rd Unit 204
Williston, VT 05495-8056

Mailing address

373 Blair Park Rd Unit 204
Williston, VT 05495-8056
Phone (802) 662-4672

Other identifiers

IdentifierTypeStateIssuer
1019108MedicaidVT

Other providers in Williston, VT

All providers in Williston, VT · Physical Therapist in Vermont

Sources for this page

Verify at the official NPI Registry.