Active NPI
Leonie Burns Nelson, P.T.
- Physical Therapist
- Essex Junction, VT
National Provider Identifier
1699806869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 040-0000844
- Practice address
- 67 Lincoln St
Champlain Physical Therapy
Essex Junction, VT 05452-3235 - Phone
- (802) 878-9513
- Fax
- (802) 878-9962
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 040-0000844 | VT | Primary |
Addresses
Primary practice location
67 Lincoln St
Champlain Physical Therapy
Essex Junction, VT 05452-3235
Mailing address
67 Lincoln St
Champlain Physical Therapy
Essex Junction, VT 05452-3235
Phone (802) 878-9513
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1008030 | Medicaid | VT | |
| 06529618 | Other | VT | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040-0000844 | VT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1699806869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 LINCOLN ST",
"address_2": "CHAMPLAIN PHYSICAL THERAPY",
"city": "ESSEX JUNCTION",
"state": "VT",
"postal_code": "054523235",
"telephone_number": "802-878-9513",
"fax_number": "802-878-9962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 LINCOLN ST",
"address_2": "CHAMPLAIN PHYSICAL THERAPY",
"city": "ESSEX JUNCTION",
"state": "VT",
"postal_code": "054523235",
"telephone_number": "802-878-9513",
"fax_number": "802-878-9962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "LEONIE",
"middle_name": "BURNS",
"name_prefix": "Ms.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VT",
"license": "040-0000844",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1008030",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "06529618",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Essex Junction, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.