Individual provider Active NPI

Marissa Ronick

  • Student in an Organized Health Care Education/Training Program
  • Burlington, VT
National Provider Identifier
1720933112
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
097.0136018 Issued in VT
Practice address
1138 Pine St
Burlington, VT 05401-5353
Phone
(802) 488-6000
Fax
(802) 488-6919
NPI assigned
Mar 2, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 097.0136018 VT Primary

Addresses

Primary practice location

1138 Pine St
Burlington, VT 05401-5353

Mailing address

102 S Winooski Ave
Burlington, VT 05401-7406
Phone (802) 488-6920

Other names 1

  • Reese Ronick Other name

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

State licenses

LicenseStateTypeSpecialty
097.0136018VTMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1772409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1720933112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S WINOOSKI AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054017406",
            "telephone_number": "802-488-6920",
            "fax_number": "802-488-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 PINE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015353",
            "telephone_number": "802-488-6000",
            "fax_number": "802-488-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONICK",
        "first_name": "MARISSA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-03-02",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VT",
            "license": "097.0136018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REESE",
            "last_name": "RONICK",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.