Active NPI
Tracy Titchner, PT
- Physical Therapist
- Williston, VT
National Provider Identifier
1962560177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 040-0002801
- Practice address
- 151 Blair Park Rd
Williston, VT 05495-7435 - Phone
- (802) 879-0909
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 040-0002801 | VT | Primary |
Addresses
Primary practice location
151 Blair Park Rd
Williston, VT 05495-7435
Mailing address
151 Blair Park Rd
PO Box 1064
Williston, VT 05495-7435
Phone (802) 879-0909
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43V034 | Other | VT | MVP |
| 00019760 | Other | VT | BCBS |
| 272923 | Other | VT | CIGNA |
| 1007612 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040-0002801 | VT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Champlain Medical Associates PLLC | Past | Accepting new patients | |
| Associates in Physical and Occupational Therapy | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Williston, VT
- NPI 1093897464
-
- Family Medicine Physician
- S Burlington, VT
- NPI 1013273697
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194998400000",
"number": "1962560177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 BLAIR PARK RD",
"address_2": "PO BOX 1064",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054957435",
"telephone_number": "802-879-0909",
"fax_number": "802-879-3095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 BLAIR PARK RD",
"city": "WILLISTON",
"state": "VT",
"postal_code": "054957435",
"telephone_number": "802-879-0909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TITCHNER",
"first_name": "TRACY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2007-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VT",
"license": "040-0002801",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "43V034",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "00019760",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "272923",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007612",
"state": "VT"
}
],
"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 Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.