Individual provider Active NPI

Ava Rae Hultgren, DC

  • Chiropractor
  • South Burlington, VT
National Provider Identifier
1093509416
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006.0134218 Issued in VT
Practice address
4 Market St Ste 2
South Burlington, VT 05403-6279
Phone
(802) 777-1913
NPI assigned
Apr 9, 2025
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006.0134218 VT Primary

Addresses

Primary practice location

4 Market St Ste 2
South Burlington, VT 05403-6279

Mailing address

4 Market St Ste 2
South Burlington, VT 05403-6279
Phone (802) 777-1913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250416003230 VT Practitioner - Chiropractic 8527583087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sommers Chiropractic LLCGroup PAC ID 4789950320, 4 clinicians

Practice addresses (Care Compare)

4 Market St
Suite 2
South Burlington, VT 05403-6279
Phone (802) 497-2938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sommers Chiropractic LLC Chiropractor CurrentSince Apr 7, 2025 Accepting new patients

Locations

4 Market St
Ste 2
South Burlington, VT 05403
Phone (802) 497-2938

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1093509416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MARKET ST STE 2",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036279",
            "telephone_number": "802-777-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MARKET ST STE 2",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036279",
            "telephone_number": "802-777-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULTGREN",
        "first_name": "AVA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "006.0134218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.