Michael John Metcalfe, MS, ATC, CSCS, CES

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT678 Issued in ME

Practice address

239 Park Ave
Portland, ME 04102-2911

Phone

(651) 285-2478

NPI assigned

Feb 17, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1235451311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 FOREST AVE STE 102",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011505",
            "telephone_number": "651-285-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 PARK AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022911",
            "telephone_number": "651-285-2478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8408 Rochester Ave",
            "address_purpose": "LOCATION",
            "city": "Rancho Cucamonga",
            "state": "CA",
            "postal_code": "917303904",
            "country_code": "US",
            "telephone_number": "651-285-2478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "METCALFE",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "MS, ATC, CSCS, CES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "1911",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ME",
            "license": "AT678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINING LICENSE",
            "identifier": "AT678",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joyce O Messier, PRACTICAL NURSE
• Yanelis Mestre, DMD
• Metanoia Compassionate Care LLC
• Heather Ashley Metcalf, MD
• Todd Metcalf, OTR/L
• Samuel Brian Methot, DPT
• Thomas Michael Meuser, PHD
• Daniel A Meyer, MD
• Gail M Meyer, FNP
• Laura Meyer, L.AC.

• Athletic Trainer in Portland, ME
• Providers in Portland, ME by specialty
• Athletic Trainer in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.