Andrew Michael McNellis, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

25MT00240200 Issued in NJ

Practice address

300 Cuthbert Blvd
Cherry Hill, NJ 08002-2904

Phone

(856) 663-2247

Fax

(856) 661-0632

NPI assigned

Jul 23, 2017

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500768000000",
    "number": "1023531944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 MICAWBER DR",
            "city": "WILLIAMSTOWN",
            "state": "NJ",
            "postal_code": "080942139",
            "telephone_number": "856-340-9524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CUTHBERT BLVD",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080022904",
            "telephone_number": "856-663-2247",
            "fax_number": "856-661-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNELLIS",
        "first_name": "ANDREW",
        "middle_name": "MICHAEL",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-23",
        "last_updated": "2017-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00240200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Patrick McMahon, M.D.
• Kevin Patrick McMenamin, DC
• Renee Terese McMichael, OTR/L
• Amy McMillan, OT
• Melissa McNamee, LAC
• Edward Martin McPherson Jr., OTRL
• Maximilian McQuade, DO
• Tiffany McSherry, MSPT
• Taylor McVay, OTR/L
• Carol McVey, MS OTR

• Athletic Trainer in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Athletic Trainer in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2017; 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.