PT 360 Inc
Organization Active NPI Physical Therapist · Williston, VT
NPI 1609183177 · NPPES record last updated Jul 16, 2020
Key facts
- NPI
- 1609183177
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- 040-0002123 (VT)
- Legal business name
- PT 360 INC
- Practice address
- 426 Industrial Ave
Suite 190
Williston, VT 05495-4448 - Phone
- (802) 860-4360
- Fax
- (802) 488-3160
- NPI assigned
- Sep 7, 2010
- Organization subpart
- No
Authorized official
- Name
- Ms. Mary Casey Steiger, PHYSICAL THERAPIST
- Title
- Board of Directors - President
- Phone
- (802) 860-4360
Practitioners 56
-
Laura Beth Clark, PT
-
James R Cummings, PT
-
Nina Dinan, PT
-
Tim Dix, DPT
-
Andrew M Eames, DPT, ATC
-
Sabrina Foster, DPT
-
Seth Mason, DPT
-
Gabrielle Shevon Young, PT, DPT
-
Sara Costa, PT
-
Lorraine Nejaime, PT
-
Emma G Roberts, PT
-
Amy N Sheridan, MSPT
-
Kramer Jakubek, PT, DPT, CSCS
-
Wendy King, PT
-
Rebecca Meryman, DPT
-
Rebecca Street, DPT
-
Michelle S Peterson, DPT
-
Erin Miceli Adams, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110120000820 | VT | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 0749469906 |
Receives reassigned benefits from 24 practitioners Practice locations: Burlington, VT; Shelburne, VT; South Burlington, VT; Williston, VT |
National Provider Directory
Locations
80 Colchester Ave
Burlington, VT 05401
Phone (802) 657-7990
241 Indian Point St
Ste 7
Newport, VT 05855
Phone (802) 334-5858
120 Graham Way
Ste 110
Shelburne, VT 05482
Phone (802) 657-7990
10 Farrell St
Ste 7
South Burlington, VT 05403
Phone (802) 318-5564
426 Industrial Ave
Ste 190
Williston, VT 05495
Phone (802) 657-7990
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 040-0002123 | VT | Yes |
| Sports Physical Therapist |
2251S0007X | 040-0002463 | VT | |
| Physical Therapy Assistant |
225200000X | |||
| Athletic Trainer |
2255A2300X | 104-0000042 | VT | |
| Physical Therapy Clinic/Center | 261QP2000X |
Addresses
Primary practice location
426 Industrial Ave
Suite 190
Williston, VT 05495-4448
Mailing address
426 Industrial Ave
Suite 190
Williston, VT 05495-7904
Phone (802) 860-4360
Other practice location 1
10 Farrell St Ste 7
South Burlington, VT 05403-6371
Phone (802) 448-9190
Other practice location 2
80 Colchester Ave
Burlington, VT 05401-1417
Phone (802) 657-7990
Other practice location 3
120 Graham Way Ste 110
Shelburne, VT 05482-7217
Phone (802) 985-9360
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1018137 | Medicaid | VT | |
| DT6174 | Other | VI | RR MEDICARE |
Other providers in Williston, VT
- David Powsner
- Dianne Patricia Prevo
- Primary Care Health Partners - Vermont LLP
- Kimberly Anne Provost
- Carrie Hutchins Pryor
- Pure Audiology LLC
- Rachel Ann Putnam
- Quality Hearing Instruments LLC
- Megan Marie Quiet
- Susan Hannah Rabin
All providers in Williston, VT · Physical Therapist in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.