Active NPI
David Terry Letourneau, LATC
- Athletic Trainer
- Caribou, ME
National Provider Identifier
1245421387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT153
- Practice address
- 7 Russ Street
Center for Integrated Neuro-Rehab
Caribou, ME 04736 - Phone
- (207) 498-3820
- Fax
- (207) 498-3591
- NPI assigned
- Aug 5, 2007
- Sex
- Male
- 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 | AT153 | ME | Primary |
Addresses
Primary practice location
7 Russ Street
Center for Integrated Neuro-Rehab
Caribou, ME 04736
Mailing address
7 Russ Street
Center for Integrated Neuro-Rehab
Caribou, ME 04736
Phone (207) 498-3820
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 |
|---|---|---|---|
| AT153 | ME | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186272000000",
"number": "1245421387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 RUSS STREET",
"address_2": "CENTER FOR INTEGRATED NEURO-REHAB",
"city": "CARIBOU",
"state": "ME",
"postal_code": "04736",
"telephone_number": "207-498-3820",
"fax_number": "207-498-3591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 RUSS STREET",
"address_2": "CENTER FOR INTEGRATED NEURO-REHAB",
"city": "CARIBOU",
"state": "ME",
"postal_code": "04736",
"telephone_number": "207-498-3820",
"fax_number": "207-498-3591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LETOURNEAU",
"first_name": "DAVID",
"middle_name": "TERRY",
"credential": "LATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-05",
"last_updated": "2007-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ME",
"license": "AT153",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caribou, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.