Michelle Dussault, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

041.0095968 Issued in VT

Practice address

262 Western Ave
- Back Apt
Brattleboro, VT 05301-6246

Phone

(813) 787-9668

NPI assigned

Dec 4, 2015

Last updated

Dec 4, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1449187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449187200000",
    "number": "1780059550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 WESTERN AVE",
            "address_2": "- BACK APT",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053016246",
            "telephone_number": "813-787-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 WESTERN AVE",
            "address_2": "- BACK APT",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053016246",
            "telephone_number": "813-787-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSSAULT",
        "first_name": "MICHELLE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-04",
        "last_updated": "2015-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MA",
            "license": "9154",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VT",
            "license": "041.0095968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elise Drapeau, ND
• Marcia Margarita Duclos, DNP
• John C Duff, O.D.
• Nancy Lynne Duncan, RN,CNM
• Michael Durante, M.S.W.
• Schniedline Duveillaume, MSW
• Samantha Kane Eagle, N.D., M.S.
• Michael Henry Earley, M.A.
• Early Education Services of Windham County, Inc
• Eden Park Management, Inc.

• Physical Therapy Assistant in Brattleboro, VT
• Providers in Brattleboro, VT by specialty
• Physical Therapy Assistant in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2015; 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.