Active NPIIndividual providerSole proprietor

Mr. Kyle J Peckham, ATC

Specialist/Technologist, Athletic Trainer in Essex Junction, Vermont

NPI Number1861889206
Practice location
10 Edgewood Dr, Essex Junction, VT 05452-3073
Fax
—
Last updated
December 10, 2015

Kyle J Peckham is a Specialist/Technologist, Athletic Trainer based in Essex Junction, VT. Kyle J Peckham practices in Essex Junction, VT and has the professional credentials of ATC. The NPI Number for Kyle J Peckham is 1861889206. The current practice location address for Kyle J Peckham is 10 Edgewood Dr, Essex Junction, VT 05452-3073 and can be reached out via phone at 802-734-6364.

Provider Profile Details

NPI Number
1861889206
Provider Name
Kyle J Peckham
Credential
ATC
Provider Entity Type
Individual
Gender
Male
Address
10 Edgewood Dr, Essex Junction, VT 05452-3073
Phone Number
802-734-6364
Primary Taxonomy
Specialist/Technologist, Athletic Trainer · 2255A2300X
Sole Proprietor
Yes
Provider Enumeration Date
April 23, 2015
Last Update Date
December 10, 2015
NPI Status
Active

Provider Business Practice Location Address Details

Address
10 Edgewood Dr
Essex Junction, VT 05452-3073
State
Vermont
Zip
05452-3073
Phone Number
802-734-6364
Essex Junction, VT 05452Get directions →

Provider Business Mailing Address Details

Address
10 Edgewood Dr
Essex Junction, VT 05452-3073
City
Essex Junction
State
VT
Zip
05452-3073
Phone Number
802-734-6364

License Information

Taxonomy (1)
Specialist/Technologist, Athletic Trainer · 2255A2300X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Mr. Kyle J Peckham, ATC?

The NPI number of Mr. Kyle J Peckham, ATC is 1861889206. It was assigned on April 23, 2015 and is currently active in the NPPES registry.

What is the specialty of Mr. Kyle J Peckham, ATC?

Mr. Kyle J Peckham, ATC is registered under the primary taxonomy Specialist/Technologist, Athletic Trainer (code 2255A2300X).

Where does Mr. Kyle J Peckham, ATC practice?

The practice location is 10 Edgewood Dr, Essex Junction, VT 05452-3073. The office can be reached at 802-734-6364 (phone).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1861889206 directly on the NPPES registry website.

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