Unknown Individual – Physical Therapist, NPI 1073517017

Unknown Individual is a healthcare provider. based in Woodstock, Vermont. specializing in Physical Therapist. They hold a License No. 040-0003099 (VT). The NPI Number for Unknown Individual is 1073517017

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1073517017
Phone
(802) 457-3215
Address
442 WOODSTOCK RD
Deactivation Date
10 April 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1975 (51 years ago)
PAC ID
9133139991
Professional Enrollment ID
I20060425000366
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Woodstock Road, Woodstock, Dubbo, Dubbo Regional Council, New South Wales, 2830, Australia

    STE 3A

    WOODSTOCK, VT 050919794

    Phone: (802) 457-3215

    Fax: (802) 457-6118

    Type: Mailing

  • 442, Woodstock Road, West Fayetteville, Franklin County, Pennsylvania, 17222, United States

    STE 3A

    WOODSTOCK, VT 050919794

    Phone: (802) 457-3215

    Fax: (802) 457-6118

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 05091)

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Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYVT97001Physical therapy evaluation6752
PHYSICAL THERAPYVT97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes6946273

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1073517017 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Woodstock, Vermont may find Unknown Individual in results; validate coverage separately.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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