Variable Movement LLC – Physical Therapist

Key facts

NPI: 1700524691
Entity type: Organization (NPI type 2)
Primary specialty: Physical Therapist 225100000X
Legal business name: VARIABLE MOVEMENT LLC
Practice address: 165 Ellsworth Rd Apt 3a
Blue Hill, ME 04614-5423
Phone: (207) 374-7228
Fax: (207) 433-1465
NPI assigned: May 22, 2022
Organization subpart: No

Authorized official

Name: Dr. Daniel C Waterman Jr., DAT, LAT, ATC NPI 1841639192
Title: President
Phone: (603) 313-4227

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

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Casey L Johnston, DPT Physical Therapist · Blue Hill, ME · NPI 1154678324

Medicare reassignment NPD ME · PHYSICAL THERAPIST
Daniel C Waterman Jr., DAT, LAT, ATC Athletic Trainer · Wilton, ME · NPI 1841639192

NPD Authorized official

Medicare participation

Medicare fee-for-service enrollment: Enrolled in ME

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20221128000346	ME	Part B Supplier - Physical/Occupational Therapy Group in Private Practice	4587032461	Receives reassigned benefits from 1 practitioner Practice locations: Blue Hill, ME

National Provider Directory

Locations

248 State St
Ste 10
Ellsworth, ME 04605
Phone (207) 374-7228

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist Group: 193400000X SINGLE SPECIALTY GROUP	225100000X			Yes

Addresses

Primary practice location

165 Ellsworth Rd Apt 3a
Blue Hill, ME 04614-5423

Mailing address

15 Upland Way
Ellsworth, ME 04605-3475
Phone (603) 313-4227

Other practice location 1

248 State St Ste 10
Ellsworth, ME 04605-1850
Phone (207) 374-7228

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 25, 2023.

{
    "created_epoch": "1653177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1700524691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 UPLAND WAY",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046053475",
            "telephone_number": "603-313-4227",
            "fax_number": "207-433-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 ELLSWORTH RD APT 3A",
            "city": "BLUE HILL",
            "state": "ME",
            "postal_code": "046145423",
            "telephone_number": "207-374-7228",
            "fax_number": "207-433-1465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "248 State St Ste 10",
            "address_purpose": "LOCATION",
            "city": "Ellsworth",
            "state": "ME",
            "postal_code": "046051850",
            "country_code": "US",
            "telephone_number": "207-374-7228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VARIABLE MOVEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-22",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "WATERMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-313-4227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DAT, LAT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Hill, ME

All providers in Blue Hill, ME · Physical Therapist in Maine

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.