David John McDermott, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT623 Issued in ME

Practice address

BLDG. H1 Julian C Smith Rd.,
Camp Lejuene, NC 28547

Phone

(207) 316-7134

NPI assigned

Dec 30, 2017

Last updated

Apr 26, 2019By the provider in NPPES

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County Physical Therapy, LLC

  • Physical Therapist
  • Caribou, ME
  • NPI 1386686616
  NPD (past)
• Northern Maine Medical Center

  dba St John Valley Pharmacy

  • Community/Retail Pharmacy
  • Fort Kent, ME
  • NPI 1952303422
  NPD (past)

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

{
    "created_epoch": "1514592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1114434032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 ST JOSEPH ST APT 102",
            "city": "FORT KENT",
            "state": "ME",
            "postal_code": "047431172",
            "telephone_number": "207-316-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG. H1 JULIAN C SMITH RD.,",
            "city": "CAMP LEJUENE",
            "state": "NC",
            "postal_code": "28547",
            "telephone_number": "207-316-7134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 E Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Kent",
            "state": "ME",
            "postal_code": "047431407",
            "country_code": "US",
            "telephone_number": "207-834-4117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-30",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ME",
            "license": "AT623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodore Sherman Branch
• Cong None Chen
• Christopher W Clark, L.A.T., A.T.C.
• Rocky Foster, IDC
• Kyle Weston Holbrook, IDC
• Rebecca Dawn Nelson-Shea, DDS
• Janice M Poston
• Joan Cross Robbins, NNP-BC
• Jessica Venegas
• Robert Weber, SOIDC

• Athletic Trainer in Camp Lejuene, NC
• Providers in Camp Lejuene, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; 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.