Active NPI
Theresa Repole, ATC
- Athletic Trainer
- Newark, DE
National Provider Identifier
1235532995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- J3-0000211
- Practice address
- 211 Executive Dr
Suite 11
Newark, DE 19702-3357 - Phone
- (302) 793-1800
- NPI assigned
- Oct 8, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | J3-0000211 | DE | Primary |
Addresses
Primary practice location
211 Executive Dr
Suite 11
Newark, DE 19702-3357
Mailing address
211 Executive Dr
Suite 11
Newark, DE 19702-3357
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
| License | State | Type | Specialty |
|---|---|---|---|
| J3-0000211 | DE | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412726400000",
"number": "1235532995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 EXECUTIVE DR",
"address_2": "SUITE 11",
"city": "NEWARK",
"state": "DE",
"postal_code": "197023357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 EXECUTIVE DR",
"address_2": "SUITE 11",
"city": "NEWARK",
"state": "DE",
"postal_code": "197023357",
"telephone_number": "302-793-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REPOLE",
"first_name": "THERESA",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-08",
"last_updated": "2014-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "DE",
"license": "J3-0000211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.