Ellsworth Physical Therapy, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

0400003140 Issued in VT

Legal business name

ELLSWORTH PHYSICAL THERAPY, INC.

Practice address

1 Market PL
Suite #33
Essex Junction, VT 05452-2942

Phone

(802) 878-9572

Fax

(802) 878-9592

NPI assigned

Jul 6, 2006

Organization subpart

No

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

Authorized official

Name

Kimberly D Ellsworth, PTNPI 1760413827

Title

Physical Therapist

Phone

(802) 879-3545

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Kimberly D Ellsworth, PT

  • Physical Therapist
  • Essex Junction, VT
  • NPI 1760413827
  NPD (past) Authorized official

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861423873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SHIRLEY CIR",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957351",
            "telephone_number": "802-879-3545",
            "fax_number": "802-878-9592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MARKET PL",
            "address_2": "SUITE #33",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522942",
            "telephone_number": "802-878-9572",
            "fax_number": "802-878-9592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLSWORTH",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "802-879-3545",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "VT",
            "license": "0400003140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008564",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Waters Dunklow
• Tilyr Alfred Dunklow, D.C., B.S.
• Mark Dziadek, MPT
• Blagorodna Efremovski, LCMHC., LADC
• Jen Ellis, M.S., M.ED.
• Kimberly D Ellsworth, PT
• Empower Therapy, LLC
• Hannah Engelken, LICSW
• Essex Family Dental
• Essex Rescue Inc

• Physical Therapy Clinic/Center in Essex Junction, VT
• Providers in Essex Junction, 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 Aug 22, 2020; 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.