Adam Robert Perreault, MED, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

001574-1 Issued in NY

Practice address

1500 Kearns Blvd
Park City, UT 84060-7226

Phone

(435) 714-9044

Fax

(435) 658-5241

NPI assigned

Mar 27, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239235200000",
    "number": "1194997437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 680751",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840680751",
            "telephone_number": "435-714-9044",
            "fax_number": "435-658-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 KEARNS BLVD",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607226",
            "telephone_number": "435-714-9044",
            "fax_number": "435-658-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERREAULT",
        "first_name": "ADAM",
        "middle_name": "ROBERT",
        "credential": "MED, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-27",
        "last_updated": "2009-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "001574-1",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "UT",
            "license": "7085752-4810",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Pearmain, PA.C
• Thomas Roger Peay, PH.D.
• Wade A Peers, D.D.S.
• Robert Eugene Pellegrine, MD
• Kristen Michelle Perlmutter, S.S.W.
• James Robert Perrone, PTA
• Jesse Perry, M.D.
• Personal PT
• Donn W Peters, PSY.D.
• Mark William Peterson, DO

• Athletic Trainer in Park City, UT
• Providers in Park City, UT by specialty
• Athletic Trainer in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.