Active NPI
Nicole Gorvin, ATR
- Athletic Trainer
- Minnetonka, MN
National Provider Identifier
1225428808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2578
- Practice address
- 5101 Highway 101
Minnetonka, MN 55345-4163 - Phone
- (952) 512-4200
- NPI assigned
- Feb 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 2578 | MN | Primary |
Addresses
Primary practice location
5101 Highway 101
Minnetonka, MN 55345-4163
Mailing address
4621 Manchester Rd
Mound, MN 55364-9141
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 |
|---|---|---|---|
| 2578 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422921600000",
"number": "1225428808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4621 MANCHESTER RD",
"city": "MOUND",
"state": "MN",
"postal_code": "553649141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5101 HIGHWAY 101",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553454163",
"telephone_number": "952-512-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORVIN",
"first_name": "NICOLE",
"credential": "ATR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-03",
"last_updated": "2015-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": "2578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.