Individual provider Active NPI

Michael A Sirois, MS, L-ATC, PES

  • Athletic Trainer
  • Manchester, NH
National Provider Identifier
1285694448
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0276 Issued in NH
Practice address
100 Saint Anselms Dr
Box 1727
Manchester, NH 03102-1308
Phone
(603) 641-7807
Fax
(603) 222-4091
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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 0276 NH Primary

Addresses

Primary practice location

100 Saint Anselms Dr
Box 1727
Manchester, NH 03102-1308

Mailing address

100 Saint Anselms Dr
Box 1727
Manchester, NH 03102-1308
Phone (603) 641-7807

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0276NHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1285694448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SAINT ANSELMS DR",
            "address_2": "BOX 1727",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031021308",
            "telephone_number": "603-641-7807",
            "fax_number": "603-222-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SAINT ANSELMS DR",
            "address_2": "BOX 1727",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031021308",
            "telephone_number": "603-641-7807",
            "fax_number": "603-222-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIROIS",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MS, L-ATC, PES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NH",
            "license": "0276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; 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.