Individual provider Active NPI

Ronna Marie Davine, PT

  • Physical Therapist
  • Rutland, VT
National Provider Identifier
1659407013
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0400002469 Issued in VT
Practice address
5 Albert Cree Dr
Vermont Sports Medicine Center
Rutland, VT 05701
Phone
(802) 775-1300
Fax
(802) 773-9300
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0400002469 VT Primary

Addresses

Primary practice location

5 Albert Cree Dr
Vermont Sports Medicine Center
Rutland, VT 05701

Mailing address

5 Albert Cree Dr
Vermont Sports Medicine Center
Rutland, VT 05701
Phone (802) 775-1300

Other identifiers 3

IdentifierTypeStateIssuer
988038OtherMVP
00004675OtherVTBLUE CROSS BLUE SHIELD OF
OVN2144MedicaidVT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060505000376 VT Practitioner - Physical Therapist in Private Practice 3678584612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Every Body PT LLCGroup PAC ID 9537495320, 4 clinicians

Practice addresses (Care Compare)

155 Woodstock Ave
Suite 2
Rutland, VT 05701-3587
Phone (802) 772-7801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Every Body PT LLC Physical Therapist CurrentSince Jul 1, 2019 Accepting new patients
Mountain View Physical Therapy PC Physical Therapist PastSince Mar 22, 1999 Accepting new patients

Locations

155 Woodstock Ave
Ste 2
Rutland, VT 05701
Phone (415) 533-4863

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659407013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 ALBERT CREE DR",
            "address_2": "VERMONT SPORTS MEDICINE CENTER",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "05701",
            "telephone_number": "802-775-1300",
            "fax_number": "802-773-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 ALBERT CREE DR",
            "address_2": "VERMONT SPORTS MEDICINE CENTER",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "05701",
            "telephone_number": "802-775-1300",
            "fax_number": "802-773-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVINE",
        "first_name": "RONNA",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "0400002469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "988038",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF",
            "identifier": "00004675",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN2144",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutland, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.