Individual provider Active NPI

Trevor Gregory Trombley, PT, DPT

  • Physical Therapist
  • Fairfax, VT
National Provider Identifier
1619220654
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
040.0090673 Issued in VT
Practice address
1282 Main St
Fairfax, VT 05454-9534
Phone
(802) 849-9308
NPI assigned
Oct 15, 2012
Last updated
Oct 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 033588-1 NY
Physical Therapist 225100000X 040.0090673 VT Primary

Addresses

Primary practice location

1282 Main St
Fairfax, VT 05454-9534

Mailing address

4 Whitney St
Norwood, NY 13668-1407
Phone (315) 447-5934

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121227000017 VT Practitioner - Physical Therapist in Private Practice 2365695301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choice Physical Therapy of St Albans LLCGroup PAC ID 0345206462, 5 clinicians

Practice addresses (Care Compare)

3 Champlain CMNS
Suite 1
Saint Albans, VT 05478-1563
Phone (802) 524-1155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033588-1NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Choice Physical Therapy of St Albans LLC Physical Therapist CurrentSince Jun 3, 2014 Accepting new patients
Fairfax Family Physical Therapy, P.C. Physical Therapist PastSince Jul 1, 2008 Accepting new patients
Rush-Select Holdings, LLC PastSince Jun 1, 2022 Accepting new patients
Fairfax Family Physical Therapy P.C. Past Accepting new patients

Locations

3 Champlain Cmns
#1
Saint Albans, VT 05478
Phone (802) 524-1155

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1619220654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WHITNEY ST",
            "city": "NORWOOD",
            "state": "NY",
            "postal_code": "136681407",
            "telephone_number": "315-447-5934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1282 MAIN ST",
            "city": "FAIRFAX",
            "state": "VT",
            "postal_code": "054549534",
            "telephone_number": "802-849-9308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROMBLEY",
        "first_name": "TREVOR",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033588-1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040.0090673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.