Andrew Martin Stull, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

104.0133941 Issued in VT

Practice address

28 Park Ave
Williston, VT 05495-9701

Phone

(802) 878-1008

NPI assigned

Dec 13, 2011

Last updated

Feb 15, 2022By 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)

Not enrolled

State licenses

Practice roles

Locations

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

• Evergreen Family Health Partners

  • Family Medicine Physician
  • Williston, VT
  • NPI 1588790562
  NPD

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

{
    "created_epoch": "1323734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1346519774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 PARK AVE",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054959701",
            "telephone_number": "802-878-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 PARK AVE",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054959701",
            "telephone_number": "802-878-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STULL",
        "first_name": "ANDREW",
        "middle_name": "MARTIN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-13",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VT",
            "license": "104.0133941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonitta C Steuer, CNM
• Martha Stitelman, MD
• Lily Stolberg, NP-C
• Katharine Ann Stones, DNP, FNP-C
• Alyssa Rae Strassel, D.C.
• Susan N. Legacy, MD PLLC
• Suzanne Monzel, PLC
• Kelly Swartz
• Erin Swasey, D.C
• Synchrosaic LLC (Catherine E Burns, PhD)

• Athletic Trainer in Williston, VT
• Providers in Williston, VT by specialty
• Athletic Trainer in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.