Gillian Butsch Berrian, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1630 Issued in WY

Practice address

4075 Jarvis Lane
Wilson, WY 83014

Phone

(802) 272-5626

NPI assigned

Jun 23, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Gillian C Butsch Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1609227362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14161",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830024161",
            "telephone_number": "307-734-1429",
            "fax_number": "307-734-1427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4075 JARVIS LANE",
            "city": "WILSON",
            "state": "WY",
            "postal_code": "83014",
            "telephone_number": "802-272-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRIAN",
        "first_name": "GILLIAN",
        "middle_name": "BUTSCH",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT1630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GILLIAN",
            "last_name": "BUTSCH",
            "middle_name": "C",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Wilson, WY
• Providers in Wilson, WY by specialty
• Physical Therapist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.