CHAMPLAIN SPORTS MEDICINE PC (NPI# 1518106491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518106491 |
| Entity Type | Organization |
| Organization Name | CHAMPLAIN SPORTS MEDICINE PC |
| Practice Address |
67 Lincoln St Essex Junction VT 05452-3235 |
| Practice Telephone | 8028781003 |
| Practice Fax Number | 8028789966 |
| Mailing Telephone | 8028781003 |
| Mailing Fax Number | 8028789966 |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2017-06-13 |
| Authorized Official Name | DR. JOHN RUSSELL JOHANSSON (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 8028781003 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 204C00000X | Neuromusculoskeletal Medicine, Sports Medicine | 0320000304 | VT | Allopathic & Osteopathic Physicians |
| Street Address |
67 LINCOLN ST |
| City | ESSEX JUNCTION |
| State | VT |
| Zip Code | 05452-3235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306829312 | Marilynne Johnson | Physical Therapist | 67 Lincoln St, Essex Junction, VT 05452-3235 | 2005-11-22 |
| 1609128164 | Vermont Center for Occupational Rehabiliation | Clinic/Center | 67 Lincoln St, Essex Junction, VT 05452-3235 | 2012-10-09 |
| 1528273851 | Mary-ellen Giroux | Psychologist | 67 Lincoln St, Essex Junction, VT 05452-3235 | 2007-05-11 |
| 1699806869 | Leonie Burns Nelson | Physical Therapist | 67 Lincoln St, Champlain Physical Therapy, Essex Junction, VT 05452-3235 | 2007-03-08 |
| 1316005960 | John Russell Johansson | Neuromusculoskeletal Medicine, Sports Medicine | 67 Lincoln St, Essex Junction, VT 05452-3235 | 2006-12-05 |
| 1629081187 | Erika Dietlinde Senft Miller | Physical Therapist | 67 Lincoln St, Essex Junction, VT 05452-3235 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356878367 | Brooke Lockwood-cole | Counselor | 10-12 Pearl Street, Essex Junction, VT 05452 | 2017-05-22 |
| 1871962332 | Cyrus Patten | Social Worker | 10-12 Pearl St., Essex Jct, VT 05452 | 2015-09-15 |
| 1881982528 | Elaine Morse | Social Worker | 27 Kellogg Road, Essex Junction, VT 05452 | 2011-07-15 |
| 1376860767 | Jessica Marie Lunardini | Internal Medicine | 87 Main St., Fahc/pcim-given Essex, Essex Jct., VT 05452 | 2010-04-26 |
| 1992911242 | Lisa Cannizzaro | Speech-Language Pathologist | 36 Thomas Ln, Essex Junction, VT 05452 | 2007-05-15 |
| 1841415676 | Carla Marie Osgood | Psychologist | 8 Pearl St, Essex Jct, VT 05452 | 2007-04-16 |
| 1497885511 | Ann Tello Ramsay | Acupuncturist | 1 Towne Marketplace, Suite 33, Essex Junction, VT 05452 | 2007-03-07 |
| 1811069644 | Donald A Majercik | Surgery | 18 Pearl Street, Essex Junction, VT 05452 | 2006-11-15 |
| 1376639021 | Dorothy Fisher | Internal Medicine | 15 Rustic Drive, Essex Jct., VT 05452 | 2006-10-04 |
| 1881789345 | James Douglas Cummings | Neuromusculoskeletal Medicine & OMM | Champlain Sports Medcine, 67 Lincoln Street, Essex Junction, VT 05452 | 2006-10-03 |
| Find all providers in zip 05452 | ||||
| Taxonomy Code | 204C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine, Sports Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316005960 | John Russell Johansson | Neuromusculoskeletal Medicine, Sports Medicine | 67 Lincoln St, Essex Junction, VT 05452-3235 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619989738 | Connecticut Valley Orthopaedics & Sports Medicine, PC | Neuromusculoskeletal Medicine, Sports Medicine | 29 Ridgewood Rd, Springfield, VT 05156-3050 | 2006-08-13 |
| 1891706693 | David L Muller | Neuromusculoskeletal Medicine, Sports Medicine | 29 Ridgewood Rd, Springfield, VT 05156-3050 | 2006-08-10 |
| City | ESSEX JUNCTION |
| Zip Code | 05452 |
Please comment or provide details below to improve the information on CHAMPLAIN SPORTS MEDICINE PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.