Active NPI
Jeremy Tiermini, MSS, ATC
- Athletic Trainer
- Canandaigua, NY
National Provider Identifier
1376675652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 001118-1
- Practice address
- 4355 Lakeshore Dr
Finger Lakes Community College
Canandaigua, NY 14424-8347 - Phone
- (585) 394-3500
- Fax
- (585) 394-5005
- NPI assigned
- Mar 12, 2007
- 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 | 001118-1 | NY | Primary |
Addresses
Primary practice location
4355 Lakeshore Dr
Finger Lakes Community College
Canandaigua, NY 14424-8347
Mailing address
94 Seneca Dr
Canandaigua, NY 14424-1145
Phone (585) 396-7259
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 |
|---|---|---|---|
| 001118-1 | NY | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376675652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 SENECA DR",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "144241145",
"telephone_number": "585-396-7259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4355 LAKESHORE DR",
"address_2": "FINGER LAKES COMMUNITY COLLEGE",
"city": "CANANDAIGUA",
"state": "NY",
"postal_code": "144248347",
"telephone_number": "585-394-3500",
"fax_number": "585-394-5005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIERMINI",
"first_name": "JEREMY",
"name_prefix": "Mr.",
"credential": "MSS, ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NY",
"license": "001118-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canandaigua, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.