Mary J. Irving, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

000054-01

Practice address

107 Schenectady Ave
Cobleskill, NY 12043-1704

Phone

(518) 255-5126

NPI assigned

Oct 21, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1013634997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984 TITUS LAKE RD",
            "city": "JEFFERSON",
            "state": "NY",
            "postal_code": "120932714",
            "telephone_number": "607-643-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SCHENECTADY AVE",
            "city": "COBLESKILL",
            "state": "NY",
            "postal_code": "120431704",
            "telephone_number": "518-255-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVING",
        "first_name": "MARY",
        "middle_name": "J.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": "000054-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melisa Lynn Hedges, RPH
• Ashley Horning, HAD
• Anita Yevgenyevna Horvath, LMFT
• Autumn House, LDO
• Bridgit Hurst, FNP-BC
• Olayemi Jafojo, M.D.
• Ann B Kelchlin, NP
• Debra Ann Kottage-Perrotto, M.S., ED.
• Lori Scranton Lasher, MS ED.
• Sara Lauterbach, PA-C

• Athletic Trainer in Cobleskill, NY
• Providers in Cobleskill, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.