Individual provider Active NPI

Luca Gianni Nicola Pedone

  • Athletic Trainer
  • University Park, PA
National Provider Identifier
1093639221
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
201 Old Main
University Park, PA 16802-1503
Phone
(240) 702-3866
NPI assigned
Aug 10, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Athletic Trainer 2255A2300X Primary

Addresses

Primary practice location

201 Old Main
University Park, PA 16802-1503

Mailing address

6903 Olson Rd
Takoma Park, MD 20912-6501
Phone (240) 702-3866

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

NPI Registry JSON

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

{
    "created_epoch": "1786320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1093639221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6903 OLSON RD",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209126501",
            "telephone_number": "240-702-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 OLD MAIN",
            "city": "UNIVERSITY PARK",
            "state": "PA",
            "postal_code": "168021503",
            "telephone_number": "240-702-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDONE",
        "first_name": "LUCA",
        "middle_name": "GIANNI NICOLA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-08-10",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Park, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.