Michael Andrew Champ

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

042.0016281 Issued in VT

Practice address

102 S Winooski Ave
Burlington, VT 05401-7406

Phone

(802) 488-6000

Fax

(802) 488-6919

NPI assigned

Apr 3, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Medstar Georgetown Medical Center, Inc

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1285636522
  NPD (past)

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1295231660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 MANSEAU ST",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054041546",
            "telephone_number": "802-847-5162",
            "fax_number": "802-315-4168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S WINOOSKI AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054017406",
            "telephone_number": "802-488-6000",
            "fax_number": "802-488-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMP",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042.0016281",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "VT",
            "license": "042.0016281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janine Cerutti, MA
• Emily Chadwick, LCMHC
• Ceana Dia Chakravarty
• Samantha Chalfin, LICSW
• Chamberlain Counseling and Consulting PLC
• Pamela Champagne
• Rhiannon Champagne, LMSW
• Champlain Orthodontic Associates
• Cynthia Marie Chan, M.D.
• Martin C Chang, M.D., PH.D.

• Child & Adolescent Psychiatry Physician in Burlington, VT
• Providers in Burlington, VT by specialty
• Child & Adolescent Psychiatry Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.