Vermont Sports Medicine Center

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

VERMONT SPORTS MEDICINE CENTER

Practice address

190 S Main St Ste 1
Rutland, VT 05701-4812

Phone

(802) 775-1300

Fax

(802) 773-9300

NPI assigned

May 28, 2008

Last updated

Jun 23, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael Fortunato

Title

Cfo

Phone

(860) 227-4256

Specialties & licenses 1

Addresses

Locations

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gina Theresa Courcelle, PT

  • Physical Therapist
  • Rutland, VT
  • NPI 1164689436
  NPD
• Jacquelyn Frasier, DPT

  • Physical Therapist
  • Rutland, VT
  • NPI 1861832495
  NPD
• Maureen Corey Gibeault, PT

  • Physical Therapist
  • Rutland, VT
  • NPI 1447261557
  NPD
• Erin Marie Gordon, DPT

  • Physical Therapist
  • Rutland, VT
  • NPI 1114941689
  NPD
• Michael John Mainolfi, PT

  • Physical Therapist
  • Rutland, VT
  • NPI 1881605822
  NPD
• Shannon M McBride, DPT

  • Physical Therapist
  • Rutland, VT
  • NPI 1356774590
  NPD
• Perry Louisa McGhee

  • Physical Therapist
  • Rutland, VT
  • NPI 1174093413
  NPD
• Gina Tieri Pezzetti Carlstrom, PT

  • Physical Therapist
  • Rutland, VT
  • NPI 1215263496
  NPD
• Ashleigh Raub

  • Physical Therapist
  • Rutland, VT
  • NPI 1700339041
  NPD
• Jennifer Nesmith Thomas, PT

  • Physical Therapist
  • Rutland, VT
  • NPI 1154417681
  NPD
• Claire Marie Connolly

  • Physical Therapist
  • Queensbury, NY
  • NPI 1740016203
  NPD
• Elizabeth Emmons Moulton, PT, DPT

  • Physical Therapist
  • Manning, SC
  • NPI 1548815954
  NPD

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782172800000",
    "number": "1689832594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 S MAIN ST STE 1",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014812",
            "telephone_number": "802-775-1300",
            "fax_number": "802-773-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 S MAIN ST STE 1",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014812",
            "telephone_number": "802-775-1300",
            "fax_number": "802-773-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERMONT SPORTS MEDICINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-28",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A",
        "authorized_official_last_name": "FORTUNATO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "860-227-4256",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vermont Physicians Clinic Dba Lee Emerson
• Vermont Physicians Clinic Dba Rutland Skin Center
• Vermont Physicians Clinic Inc. (Michael Garcia MD)
• Vermont Physicians Clinic Laboratory
• Vermont Physicians Clinic Laboratory Dba Mid VT Neurology
• Vermont Sports Medicine Center
• Vermont Villas Senior Living LLC
• David Viscido, MD
• Vna & Hospice of the Southwest Region, Inc
• Vna & Hospice of the Southwest Region, Inc

• Prosthetic/Orthotic Supplier in Rutland, VT
• Providers in Rutland, VT by specialty
• Prosthetic/Orthotic Supplier in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; 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.