Sara Packard, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT707 Issued in ME

Practice address

925 Union St Ste 3
Bangor, ME 04401-3051

Phone

(207) 973-8839

NPI assigned

Jul 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1366060634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 UNION ST STE 3",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 UNION ST STE 3",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013051",
            "telephone_number": "207-973-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKARD",
        "first_name": "SARA",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ME",
            "license": "AT707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC",
            "identifier": "2000033450",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spackard@northernlight.org",
            "affiliation": "N",
            "address_1": "925 Union St Ste 3",
            "city": "Bangor",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044013051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adekunle Mojeed Owolabi, MD
• Paul Jeremy Oxman, LCSW
• Pallavi Ozarde, PT
• Michael Paci, MD
• Bruce Packard, D.C.
• Katricia Rose Padula, MSW, LMSW-CC
• Sherry Sue Page, M.D.
• Irina V Pagula, CRNA
• Vasavi Paidpally, M.D.
• Kelly E Palchik, DMD

• Athletic Trainer in Bangor, ME
• Providers in Bangor, ME by specialty
• Athletic Trainer in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.