Michael R. Derosier, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0360 Issued in NH

Practice address

Dartmouth College
Alumni Gymnasium, HB 6083
Hanover, NH 03755

Phone

(603) 646-9772

Fax

(603) 646-9941

NPI assigned

Dec 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242777600000",
    "number": "1295897833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1892 CHRISTIAN ST",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050015402",
            "telephone_number": "802-295-1934",
            "fax_number": "603-646-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DARTMOUTH COLLEGE",
            "address_2": "ALUMNI GYMNASIUM, HB 6083",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "03755",
            "telephone_number": "603-646-9772",
            "fax_number": "603-646-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSIER",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2009-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00060500",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NH",
            "license": "0360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee E Davis, LADC, LMHC
• Paul M Decker, DDS
• Deer Creek Psychological Associates, PA
• Christine Carney Demment, PH.D.
• Bryant D Denk, DDS
• Jennifer Dexter, FNP
• Timothy Michael Digiacomo, PSY.D.
• Jeremy C Domina, OTR
• Donald J. Neely, DMD, Ms, PC
• Lois H Donelson, PT, DIP MDT

• Athletic Trainer in Hanover, NH
• Providers in Hanover, NH by specialty
• Athletic Trainer in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.