Active NPI
Mark Andrew Lebeda, ATC
- Athletic Trainer
- Taunton, MA
National Provider Identifier
1326799644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2119
- Practice address
- 207 Hart St
Taunton, MA 02780-3715 - Phone
- (774) 961-9062
- NPI assigned
- Jan 18, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 | 2119 | MA | Primary |
Addresses
Primary practice location
207 Hart St
Taunton, MA 02780-3715
Mailing address
99 Clayton St
Attleboro, MA 02703-7011
Phone (609) 658-1558
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 |
|---|---|---|---|
| 2119 | MA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642464000000",
"number": "1326799644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 CLAYTON ST",
"city": "ATTLEBORO",
"state": "MA",
"postal_code": "027037011",
"telephone_number": "609-658-1558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 HART ST",
"city": "TAUNTON",
"state": "MA",
"postal_code": "027803715",
"telephone_number": "774-961-9062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEBEDA",
"first_name": "MARK",
"middle_name": "ANDREW",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-18",
"last_updated": "2022-01-18",
"certification_date": "2022-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "2119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taunton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.