Individual provider Active NPI

Ryan James Gouvin

  • Student in an Organized Health Care Education/Training Program
  • South Burlington, VT
National Provider Identifier
1174490213
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
097.0135520 Issued in VT
Practice address
56 W Twin Oaks Ter Ste 3
South Burlington, VT 05403-7138
Phone
(802) 448-0121
NPI assigned
Oct 22, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 097.0135520 VT Primary

Addresses

Primary practice location

56 W Twin Oaks Ter Ste 3
South Burlington, VT 05403-7138

Mailing address

56 W Twin Oaks Ter Ste 3
South Burlington, VT 05403-7138
Phone (802) 448-0121

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

LicenseStateTypeSpecialty
097.0135520VTMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1174490213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 W TWIN OAKS TER STE 3",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037138",
            "telephone_number": "802-448-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 W TWIN OAKS TER STE 3",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037138",
            "telephone_number": "802-448-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUVIN",
        "first_name": "RYAN",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VT",
            "license": "097.0135520",
            "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 Oct 22, 2025; 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.