Heather Marie Chernyshov, MS, ATC, NCTMB
Individual provider Active NPI Athletic Trainer · Williston, VT
NPI 1124121454 · NPPES record last updated Oct 15, 2008
Key facts
- NPI
- 1124121454
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 104-0000087 (VT)
- Practice address
- 115 Wellness Dr
Williston, VT 05495-2088 - Phone
- (802) 860-1358
- NPI assigned
- Sep 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104-0000087 | VT | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Center of Vermont LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 104-0000087 | VT | Yes |
Addresses
Primary practice location
115 Wellness Dr
Williston, VT 05495-2088
Mailing address
115 Wellness Dr
Williston, VT 05495-2088
Phone (802) 860-1358
Other providers in Williston, VT
- Champlain Valley Speech Therapy
- Taylor Christine Champlin
- Diane Charland
- Maghan Charland
- Savannah Cheeseman
- Erin A Chicoine
- Child Care Resource
- Jangkyu Choi
- Soyoon Chun
- Martha Elizabeth Churchill
All providers in Williston, VT · Athletic Trainer in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.