Patrick Deachilla, MS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A0000409 Issued in MD

Practice address

5601 Loch Raven Blvd
Russell Morgan Building Suite 405
Baltimore, MD 21239-2945

Phone

(443) 444-4764

NPI assigned

Mar 26, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1245657477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 E CROSS ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212304126",
            "telephone_number": "717-515-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "RUSSELL MORGAN BUILDING SUITE 405",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "443-444-4764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEACHILLA",
        "first_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MD",
            "license": "A0000409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rafael Almeida De Oliveira, MD
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• Miguel Adrian De Souza Peixoto
• Naomi Ruth Estolas De Tablan, D.P.M.
• Stephanie Hope Solter De Wit, MD
• Kenneth Jerome Deacon, DDS
• Isabel Deakins, OD
• Jasmin Monet Deal, RBT
• Kaitlyn M Dealy
• Atiya Dean Graham

• Athletic Trainer in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Athletic Trainer in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.

Verify at the official NPI Registry.