Amanda Grace Merrell, ATC, LAT
Individual provider Active NPI Athletic Trainer · Cedarville, OH
NPI 1053901835 · NPPES record last updated Jan 25, 2021
Key facts
- NPI
- 1053901835
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- AT006292 (OH)
- Practice address
- 251 N Main St
Cedarville, OH 45314-8564 - Phone
- (513) 377-5408
- NPI assigned
- Jan 25, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT006292 | OH | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT006292 | OH | Yes |
Addresses
Primary practice location
251 N Main St
Cedarville, OH 45314-8564
Mailing address
928 Springbrook Dr
Cincinnati, OH 45224-1609
Phone (513) 377-5408
Other providers in Cedarville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.