Chris T Poulin, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

104-0000045 Issued in VT

Practice address

7 Fayette Dr
South Burlington, VT 05403-6977

Phone

(802) 658-0949

NPI assigned

Feb 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255475844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LIBERTY LN",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054466039",
            "telephone_number": "802-879-2951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 FAYETTE DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036977",
            "telephone_number": "802-658-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULIN",
        "first_name": "CHRIS",
        "middle_name": "T",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VT",
            "license": "104-0000045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Kristina Pollvogt, MA
• Lizabeth Jane Pontzer, M.D.
• Megan Poor, LICSW
• Anisa Potvin, LADC
• Poulin Performance, Inc. (Poulin Performance and Rehabilitation Center)
• Powerback Pediatrics of Vermont, LLC
• Liana Preto Webber, DDS, PHD
• Desiree Anne Price, CRNP
• Derek Prichard
• Professional Nurses Service Inc

• Athletic Trainer in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Athletic Trainer in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.