Individual provider Active NPI

Michael Casselman, MAS, ATC,CES

  • Athletic Trainer
  • Morgantown, WV
National Provider Identifier
1205368057
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
30779 Issued in WV
Practice address
943 Maple Dr
Morgantown, WV 26505-2812
Phone
(304) 599-2515
Fax
(304) 285-3738
NPI assigned
Mar 31, 2017
Last updated
Mar 31, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 30779 WV Primary

Addresses

Primary practice location

943 Maple Dr
Morgantown, WV 26505-2812

Mailing address

943 Maple Drive
Healthworks Rehab and Fitness
Morgantown, WV 26505
Phone (304) 599-2515

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

State licenses

LicenseStateTypeSpecialty
30779WVMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1205368057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 MAPLE DRIVE",
            "address_2": "HEALTHWORKS REHAB AND FITNESS",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26505",
            "telephone_number": "304-599-2515",
            "fax_number": "304-285-3738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 MAPLE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052812",
            "telephone_number": "304-599-2515",
            "fax_number": "304-285-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSELMAN",
        "first_name": "MICHAEL",
        "credential": "MAS, ATC,CES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-31",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WV",
            "license": "30779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; 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.