Active NPI
John Bruss, ATC
- Athletic Trainer
- Colchester, VT
National Provider Identifier
1932473642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 104-0073153
- Practice address
- 441 Watertower Cir
Suite 100
Colchester, VT 05446-5801 - Phone
- (802) 655-7575
- Fax
- (802) 655-1115
- NPI assigned
- Feb 27, 2012
- Last updated
- Feb 27, 2012
- Sex
- Male
- 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 | 104-0073153 | VT | Primary |
Addresses
Primary practice location
441 Watertower Cir
Suite 100
Colchester, VT 05446-5801
Mailing address
441 Watertower Cir
Suite 100
Colchester, VT 05446-5801
Phone (802) 655-7575
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
| License | State | Type | Specialty |
|---|---|---|---|
| 104-0073153 | VT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330300800000",
"number": "1932473642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "441 WATERTOWER CIR",
"address_2": "SUITE 100",
"city": "COLCHESTER",
"state": "VT",
"postal_code": "054465801",
"telephone_number": "802-655-7575",
"fax_number": "802-655-1115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "441 WATERTOWER CIR",
"address_2": "SUITE 100",
"city": "COLCHESTER",
"state": "VT",
"postal_code": "054465801",
"telephone_number": "802-655-7575",
"fax_number": "802-655-1115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUSS",
"first_name": "JOHN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-27",
"last_updated": "2012-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "VT",
"license": "104-0073153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colchester, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.