Active NPI
Erin R Vaillancourt, DPT
- Physical Therapist
- Minden, NV
National Provider Identifier
1477500320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1982
- Practice address
- 2869 Esaw St
Minden, NV 89423-9059 - Phone
- (775) 235-8809
- Fax
- (775) 420-4675
- NPI assigned
- May 27, 2006
- 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 | 1982 | NV | Primary |
Addresses
Primary practice location
2869 Esaw St
Minden, NV 89423-9059
Mailing address
2869 Esaw Street
Minden
Minden, NV 89423
Phone (775) 235-8809
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477500320 | Medicaid | NV |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carson Physical Therapy, Inc. | 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 and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Carson City, NV
- NPI 1528191749
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716422400000",
"number": "1477500320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2869 ESAW STREET",
"address_2": "MINDEN",
"city": "MINDEN",
"state": "NV",
"postal_code": "89423",
"telephone_number": "775-235-8809",
"fax_number": "775-420-4675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2869 ESAW ST",
"city": "MINDEN",
"state": "NV",
"postal_code": "894239059",
"telephone_number": "775-235-8809",
"fax_number": "775-420-4675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAILLANCOURT",
"first_name": "ERIN",
"middle_name": "R",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-27",
"last_updated": "2024-05-23",
"certification_date": "2024-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "1982",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1477500320",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minden, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.