Individual provider Active NPI

Travis Donald Warmouth, MS, ATC,LAT

  • Athletic Trainer
  • Essex Junction, VT
National Provider Identifier
1265660971
Registry record updated Jul 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
104-0000171 Issued in VT
Practice address
86 Pinecrest Dr
Condo 7E
Essex Junction, VT 05452-4413
Phone
(802) 881-9609
NPI assigned
Jul 1, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2009

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 104-0000171 VT Primary

Addresses

Primary practice location

86 Pinecrest Dr
Condo 7E
Essex Junction, VT 05452-4413

Mailing address

86 Pincrest Dr.
Condo 7#
Essex Junction, VT 05452
Phone (802) 881-9609

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
104-0000171VTMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246406400000",
    "number": "1265660971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 PINCREST DR.",
            "address_2": "CONDO 7#",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "05452",
            "telephone_number": "802-881-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 PINECREST DR",
            "address_2": "CONDO 7E",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054524413",
            "telephone_number": "802-881-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARMOUTH",
        "first_name": "TRAVIS",
        "middle_name": "DONALD",
        "name_prefix": "Mr.",
        "credential": "MS, ATC,LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-01",
        "last_updated": "2009-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VT",
            "license": "104-0000171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex Junction, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; 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.