Susan Dodge, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040-0002127 Issued in VT

Practice address

21 Gregory Dr
South Burlington, VT 05403-6080

Phone

(802) 658-0949

NPI assigned

Dec 11, 2006

Last updated

Aug 12, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Rehabgym IncGroup PAC ID 5092619411, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Rehabgym Inc

  • Physical Therapist
  • Williston, VT
  • NPI 1750421772
  Medicare reassignment Care Compare group NPD
• Peak Physical Therapy Sports and Performance Center, LLC

  dba Poulin Performance and Rehabilitation Center

  • Physical Therapy Clinic/Center
  • South Burlington, VT
  • NPI 1184057143
  Authorized official Same address or phone
• Whole Health Nutrition, PLLC

  • Registered Dietitian
  • Colchester, VT
  • NPI 1205103017
  NPD (past)

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1568522506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 GREGORY DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036080",
            "telephone_number": "802-658-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 GREGORY DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036080",
            "telephone_number": "802-658-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODGE",
        "first_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040-0002127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Lynn Diederich, D.C.
• Shon Christopher Diguglielmo, D.D.S.
• Cara Dimasi, N.P.
• Mark Chipman Dobson, DTR
• Doctor Elizabeth Jensen Psychiatry Professional Corporation (Jensen Psychiatry)
• Sara Doll, M.S. ED. CCC-SLP
• Elizabeth Donahue, MSW, LICSW
• Dorset Street Dermatology
• Dorset Street Family Dental PLC
• Stephanie Kay Douglas, PT

• Physical Therapist in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Physical Therapist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; 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.