Kelsey Lyn Pengitore, ATHLETIC TRAINER

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

25MT00188800 Issued in NJ

Practice address

111 Madison Ave Ste 110
Morristown, NJ 07960-6083

Phone

(862) 260-7174

NPI assigned

Oct 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1215535042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 HUDSON PL APT 2",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034010",
            "telephone_number": "973-997-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MADISON AVE STE 110",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606083",
            "telephone_number": "862-260-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENGITORE",
        "first_name": "KELSEY",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "ATHLETIC TRAINER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00188800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "25MT00188800",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kelsey.pengitore@atlantichealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "111 Madison Ave Ste 110",
            "city": "Morristown",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "079606083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eleni Pellazgu
• Annemarie Louise Pelle, MD
• Paul Joseph Pellicano, M.D.
• Christopher Pellino, D.C.
• Thelma Mercedes Pena, MD
• Lisset - Penton, DDS
• People Helping People in Need
• Kathryn Peper, M.D
• Courtney Pepper
• Stacie Vernick Perdue, PH.D.

• Athletic Trainer in Morristown, NJ
• Providers in Morristown, NJ by specialty
• Athletic Trainer in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.