Individual provider Active NPI

Angela Lynn Palonis, ATC

  • Athletic Trainer
  • Waterville, ME
National Provider Identifier
1245388677
Registry record updated May 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT37 Issued in ME
Practice address
30 Chase Ave
Waterville, ME 04901-4624
Phone
(207) 872-4400
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2021

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 AT37 ME Primary

Addresses

Primary practice location

30 Chase Ave
Waterville, ME 04901-4624

Mailing address

16 Nickerson Rd
Holden, ME 04429-7543
Phone (207) 649-0127

Other names 1

  • Angela Duplessis Former name

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
AT37MEMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622419200000",
    "number": "1245388677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 NICKERSON RD",
            "city": "HOLDEN",
            "state": "ME",
            "postal_code": "044297543",
            "telephone_number": "207-649-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CHASE AVE",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014624",
            "telephone_number": "207-872-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALONIS",
        "first_name": "ANGELA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2021-05-31",
        "certification_date": "2021-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ME",
            "license": "AT37",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "DUPLESSIS",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waterville, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2021; 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.