Active NPI
Michele Dell-Pruett, PHD, LAT, ATC
- Athletic Trainer
- Baltimore, MD
National Provider Identifier
1063878437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- A0000683
- Practice address
- 822 W Lake Ave
Baltimore, MD 21210-1241 - Phone
- (410) 377-5192
- NPI assigned
- Jan 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | A0000683 | MD | Primary |
Addresses
Primary practice location
822 W Lake Ave
Baltimore, MD 21210-1241
Mailing address
3301 Ralph Dell Rd
Hampstead, MD 21074-1131
Phone (615) 427-1077
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A0000683 | MD | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452729600000",
"number": "1063878437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3301 RALPH DELL RD",
"city": "HAMPSTEAD",
"state": "MD",
"postal_code": "210741131",
"telephone_number": "615-427-1077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "822 W LAKE AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212101241",
"telephone_number": "410-377-5192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELL-PRUETT",
"first_name": "MICHELE",
"name_prefix": "Dr.",
"credential": "PHD, LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-14",
"last_updated": "2016-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MD",
"license": "A0000683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.