Active NPI
Michelle Goodrich, ATC, ED.M.
- Athletic Trainer
- Chestnut Hill, MA
National Provider Identifier
1376942235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1768
- Practice address
- 400 Heath St
Chestnut Hill, MA 02467-2332 - Phone
- (617) 731-7057
- Fax
- (617) 731-7035
- NPI assigned
- Aug 17, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 1768 | MA | Primary |
Addresses
Primary practice location
400 Heath St
Chestnut Hill, MA 02467-2332
Mailing address
400 Heath St
Chestnut Hill, MA 02467-2332
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 |
|---|---|---|---|
| 1768 | MA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408233600000",
"number": "1376942235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 HEATH ST",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024672332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 HEATH ST",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024672332",
"telephone_number": "617-731-7057",
"fax_number": "617-731-7035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODRICH",
"first_name": "MICHELLE",
"credential": "ATC, ED.M.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-17",
"last_updated": "2014-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MA",
"license": "1768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chestnut Hill, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.