Doug McCorkle PT

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

040-0003309 Issued in VT

Legal business name

DOUG MCCORKLE PT

Practice address

247 Canoe Brook Rd
E Dummerston, VT 05346-9770

Phone

(802) 387-3025

Fax

(802) 387-3025

NPI assigned

Feb 11, 2010

Last updated

Feb 11, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Douglas R McCorkle, PTNPI 1407866437

Title

Owner

Phone

(802) 387-3025

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Douglas R McCorkle, PT

  • Physical Therapist
  • E Dummerston, VT
  • NPI 1407866437
  NPD (past) Authorized official

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1801128111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 CANOE BROOK RD",
            "city": "E DUMMERSTON",
            "state": "VT",
            "postal_code": "053469770",
            "telephone_number": "802-387-3025",
            "fax_number": "802-387-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 CANOE BROOK RD",
            "city": "E DUMMERSTON",
            "state": "VT",
            "postal_code": "053469770",
            "telephone_number": "802-387-3025",
            "fax_number": "802-387-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUG MCCORKLE PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "MCCORKLE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-387-3025",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VT",
            "license": "040-0003309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "49955",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN2522",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11325931",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Rose Bowen, MA, LCMHC, R-DMT
• Douglas R McCorkle, PT

• Physical Therapy Clinic/Center in E Dummerston, VT
• Providers in E Dummerston, VT by specialty
• Physical Therapy Clinic/Center in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.