Individual provider Active NPI

Clare Elaine Watkin

  • Physical Therapist
  • Colchester, VT
National Provider Identifier
1477662591
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040-0003390 Issued in VT
Practice address
790 College Pkwy
Rehabilitation Outpatient Center
Colchester, VT 05446-3007
Phone
(802) 847-1906
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

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 040-0003390 VT Primary

Addresses

Primary practice location

790 College Pkwy
Rehabilitation Outpatient Center
Colchester, VT 05446-3007

Mailing address

1 Canamak W
Grand Isle, VT 05458-2343
Phone (802) 372-8788

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091216000458 VT Practitioner - Physical Therapist in Private Practice 8921148370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Plus LLCGroup PAC ID 1355575465, 2 clinicians

Practice addresses (Care Compare)

210 Route 9 E
Wilmington, VT 05363-9526
Phone (802) 464-3151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040-0003390VTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
PT Plus, LLC Physical Therapist CurrentSince Aug 5, 2013 Accepting new patients
Physical Therapy Plus LLC Physical Therapist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477662591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CANAMAK W",
            "city": "GRAND ISLE",
            "state": "VT",
            "postal_code": "054582343",
            "telephone_number": "802-372-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 COLLEGE PKWY",
            "address_2": "REHABILITATION OUTPATIENT CENTER",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054463007",
            "telephone_number": "802-847-1906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKIN",
        "first_name": "CLARE",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040-0003390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colchester, 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.