Provider Demographics
NPI:1164482154
Name:CUMMINGS, JAMES R (PT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:CUMMINGS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:426 INDUSTRIAL AVE
Mailing Address - Street 2:STE 190
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-7904
Mailing Address - Country:US
Mailing Address - Phone:802-489-6245
Mailing Address - Fax:802-876-7095
Practice Address - Street 1:1 MARKET PLACE
Practice Address - Street 2:SUITES 27 & 33
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452
Practice Address - Country:US
Practice Address - Phone:802-878-9572
Practice Address - Fax:802-878-9592
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0400002601225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
753448OtherCIGNA
18208OtherBLUE CROSS BLUE SHIELD
43V301OtherMVP
CU2036Medicare ID - Type Unspecified
VN2036Medicare ID - Type Unspecified