Active NPI
Kelly J Tourville, MED, ATC
- Athletic Trainer
- Burlington, VT
National Provider Identifier
1760558209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 104-0000013
- Practice address
- University of Vermont
213 B Patrick Gymnasium
Burlington, VT 05405-0001 - Phone
- (802) 656-7741
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 104-0000013 | VT | Primary |
Addresses
Primary practice location
University of Vermont
213 B Patrick Gymnasium
Burlington, VT 05405-0001
Mailing address
219 Juniper Dr
South Burlington, VT 05403-5793
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104-0000013 | VT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760558209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 JUNIPER DR",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054035793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "UNIVERSITY OF VERMONT",
"address_2": "213 B PATRICK GYMNASIUM",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054050001",
"telephone_number": "802-656-7741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOURVILLE",
"first_name": "KELLY",
"middle_name": "J",
"credential": "MED, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VT",
"license": "104-0000013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.