Charles Scott Vandebogart Jr., ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

2 Front St
Millbrook, NY 12545-5948

Phone

(845) 677-5021

NPI assigned

Jul 21, 2017

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1500595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500595200000",
    "number": "1700309671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 MEADOW RIDGE LN",
            "city": "LAGRANGEVILLE",
            "state": "NY",
            "postal_code": "125405224",
            "telephone_number": "845-380-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FRONT ST",
            "city": "MILLBROOK",
            "state": "NY",
            "postal_code": "125455948",
            "telephone_number": "845-677-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEBOGART",
        "first_name": "CHARLES",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-21",
        "last_updated": "2017-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Thorpe
• Elizabeth Mary Tidler, RN
• Margaret Anne Jamie Turndorf, PH.D. LCSWR
• Jenna Turner, PT, DPT
• Roberto Valoy Jr.
• Melinda Vazquez, LMSW
• Vernon Peryea,Optometrist LLC (Millbrook Family Eyecare)
• Vincents Pharmacy Inc
• William S. Bremiller (Millbrook Orthopedic & Sports Physical Therapy)
• Donna B Yerry, R.N.

• Athletic Trainer in Millbrook, NY
• Providers in Millbrook, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2017; 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.