Organization Active NPI

Amy D. Candon, PT, PLC

  • Physical Therapy Clinic/Center
  • South Burlington, VT
National Provider Identifier
1639554496
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
040.0003503 Issued in VT
Legal business name
AMY D. CANDON, PT, PLC
Practice address
1 Kennedy Dr Unit 3
South Burlington, VT 05403-7152
Phone
(802) 863-3323
NPI assigned
Jul 22, 2015
Last updated
May 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

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

Authorized official

Name
Amy D CandonNPI 1013985795
Title
Physical Therapist
Phone
(802) 238-0446

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 040.0003503 VT Primary

Addresses

Primary practice location

1 Kennedy Dr Unit 3
South Burlington, VT 05403-7152

Mailing address

1 Kennedy Dr Unit 3
South Burlington, VT 05403-7152

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151016001388 VT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4688983448 Receives reassigned benefits from 1 practitioner
Practice locations: South Burlington, VT

National Provider Directory

National Provider Directory

Locations

1 Kennedy Dr
Uppr 34
South Burlington, VT 05403

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1639554496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KENNEDY DR UNIT 3",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KENNEDY DR UNIT 3",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037152",
            "telephone_number": "802-863-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY D. CANDON, PT, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "CANDON",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "802-238-0446"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VT",
            "license": "040.0003503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.