Active NPI
Victoria May Vintevoghel, MHSA, AT, ATC
- Athletic Trainer
- Clarkston, MI
National Provider Identifier
1093067142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2601000877
- Practice address
- 6590 Middle Lake Rd
Clarkston, MI 48346-2423 - Phone
- (248) 623-5608
- NPI assigned
- Oct 12, 2012
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2601000877 | MI | Primary |
Addresses
Primary practice location
6590 Middle Lake Rd
Clarkston, MI 48346-2423
Mailing address
3214 Donna Dr
Sterling Heights, MI 48310-2904
Phone (586) 321-8127
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2601000877 | MI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350000000000",
"number": "1093067142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3214 DONNA DR",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483102904",
"telephone_number": "586-321-8127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6590 MIDDLE LAKE RD",
"city": "CLARKSTON",
"state": "MI",
"postal_code": "483462423",
"telephone_number": "248-623-5608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VINTEVOGHEL",
"first_name": "VICTORIA",
"middle_name": "MAY",
"credential": "MHSA, AT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-12",
"last_updated": "2012-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "2601000877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarkston, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.