Individual provider Active NPI

Courtney B Kaup, DPT

  • Physical Therapist
  • Williston, VT
National Provider Identifier
1730146762
Registry record updated Oct 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0400003724 Issued in VT
Practice address
20 Winter Sport LN Ste 155
Williston, VT 05495-8147
Phone
(802) 876-6000
NPI assigned
Apr 26, 2006
Last updated
Oct 30, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2014

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 0400003724 VT Primary

Addresses

Primary practice location

20 Winter Sport LN Ste 155
Williston, VT 05495-8147

Mailing address

115 Bear Run Rd Unit 18
Bolton Valley, VT 05477-4404
Phone (720) 838-1221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070910000209 VT Practitioner - Physical Therapist in Private Practice 6103867312 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0400003724VTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dee Physical Therapy Services PLC Physical Therapist CurrentSince Feb 29, 2016 Accepting new patients
Whole Health Nutrition, PLLC Past Accepting new patients
The Rehabgym Inc Physical Therapist PastSince Jun 20, 2005 Accepting new patients

Locations

166 Athletic Dr
Shelburne, VT 05482
Phone (802) 651-9090

23 San Remo Dr
Ste 101
South Burlington, VT 05403
Phone (802) 865-0010

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414627200000",
    "number": "1730146762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 BEAR RUN RD UNIT 18",
            "city": "BOLTON VALLEY",
            "state": "VT",
            "postal_code": "054774404",
            "telephone_number": "720-838-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WINTER SPORT LN STE 155",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054958147",
            "telephone_number": "802-876-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUP",
        "first_name": "COURTNEY",
        "middle_name": "B",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2014-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VT",
            "license": "0400003724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.