Michelle Lee Black, ATC
Specialist/Technologist, Athletic Trainer in Burlington, VT. Individual provider (NPI-1).
NPI number1295879351
StatusActive
Last updated in NPPESJul 11, 2016
Details
- NPI
- 1295879351
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Michelle Lee Black
- Credential
- ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 20, 2007
- Last updated
- Jul 11, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 104-0000139 | VT | Yes |
Practice location
431 Pine St Ste G01Burlington, VT 05401-4726
Phone 802-272-7383
Mailing address
431 Pine St Ste G01Burlington, VT 05401-4726
Phone 802-272-7383
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 25 Athletic Trainer providers in Burlington · All 3,832 providers in Burlington
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