Evan Robert Laz Flynn, P.T.,D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

040.0133981 Issued in VT

Practice address

321 Main St Ste D
Winooski, VT 05404-1380

Phone

(802) 864-3785

Fax

(802) 864-0274

NPI assigned

Jan 7, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521849600000",
    "number": "1679939581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MAIN ST STE D",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054041380",
            "telephone_number": "802-864-3785",
            "fax_number": "802-864-0274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MAIN ST STE D",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054041380",
            "telephone_number": "802-864-3785",
            "fax_number": "802-864-0274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "EVAN",
        "middle_name": "ROBERT LAZ",
        "name_prefix": "Dr.",
        "credential": "P.T.,D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-07",
        "last_updated": "2018-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "293084",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "4587",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "040.0133981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lara Elizabeth Dusek
• Alexandra Evans
• Kara Joyce Fauth, LICSW
• Christine Elizabeth Fellerhoff, LCSW
• Jonathan Eric Fenton, D.O.
• Deirdre M. Folsom, PT WCS
• Cheyenne Kimberley Fowler, APRN
• Elizabeth Rose Gagne, PHARMD, RPH
• Jason Robert Gamelin
• David Gauthier, MA

• Physical Therapist in Winooski, VT
• Providers in Winooski, VT by specialty
• Physical Therapist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2018; 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.