Individual provider Active NPI

Debra L Levesque, ATC, LMT

  • Athletic Trainer
  • Wareham, MA
National Provider Identifier
1205986767
Registry record updated Sep 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
734 Issued in MA
Practice address
24B Sandwich Rd
Wareham, MA 02571-1628
Phone
(508) 965-3974
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 734 MA Primary
Massage Therapist 225700000X 673 MA

Addresses

Primary practice location

24B Sandwich Rd
Wareham, MA 02571-1628

Mailing address

30 Russell St
Taunton, MA 02780-1418
Phone (508) 823-7506

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
673MAMDChiropractor
734MAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253836800000",
    "number": "1205986767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 RUSSELL ST",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027801418",
            "telephone_number": "508-823-7506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24B SANDWICH RD",
            "city": "WAREHAM",
            "state": "MA",
            "postal_code": "025711628",
            "telephone_number": "508-965-3974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVESQUE",
        "first_name": "DEBRA",
        "middle_name": "L",
        "credential": "ATC, LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2009-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "734",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MA",
            "license": "673",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wareham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.