Individual provider Active NPI

Eric Scott Gormont, MS, ATC

  • Athletic Trainer
  • Altoona, PA
National Provider Identifier
1124218235
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
RT003833 Issued in PA
Practice address
5720 Ohio Ave
Altoona, PA 16602-1145
Phone
(814) 940-1131
NPI assigned
Jul 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT003833 PA Primary

Addresses

Primary practice location

5720 Ohio Ave
Altoona, PA 16602-1145

Mailing address

5720 Ohio Ave
Altoona, PA 16602-1145
Phone (814) 940-1131

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
RT003833PAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1124218235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5720 OHIO AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166021145",
            "telephone_number": "814-940-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5720 OHIO AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166021145",
            "telephone_number": "814-940-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMONT",
        "first_name": "ERIC",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT003833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.