Individual provider Active NPI

Melissa Pearl Longnecker, MS, ATC

  • Athletic Trainer
  • Danville, PA
National Provider Identifier
1053643916
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
RT004350 Issued in PA
Practice address
115 Woodbine LN
Danville, PA 17821-9118
Phone
(570) 271-5555
NPI assigned
Feb 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT004350 PA Primary

Addresses

Primary practice location

115 Woodbine LN
Danville, PA 17821-9118

Mailing address

717 Ash St
Watsontown, PA 17777-1104
Phone (814) 573-2585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
RT004350PAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1053643916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 ASH ST",
            "city": "WATSONTOWN",
            "state": "PA",
            "postal_code": "177771104",
            "telephone_number": "814-573-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WOODBINE LN",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178219118",
            "telephone_number": "570-271-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGNECKER",
        "first_name": "MELISSA",
        "middle_name": "PEARL",
        "credential": "MS, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-03",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT004350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.